BeneSys, Inc. · 3 hours ago
Healthcare Service Representative (Troy, MI)
Troy, MI
Full-time
Onsite
New Grad, Entry Level
$23/hr - $23/hrBeneSys, Inc. is a company focused on providing excellent service to its members, and they are seeking a Healthcare Service Representative. The role involves answering participant calls regarding eligibility and enrollment, maintaining member eligibility, and assisting with various benefit-related inquiries.
IT Management
Responsibilities
Answer participant calls, mail participant requests and resolve participant issues
Know the plan rules for eligibility as outlined in the Summary Plan Description (SPD) for each fund
Assist members and their dependents with all issues regarding eligibility for benefits
Explain eligibility rules to members
Send proper enrollment documents to members adding children or a spouse
Enrollment verifications
Death Notifications
Communicate with various vendors regarding prior authorizations and eligibility issues
Comment system when changes are made to Participant record or when Participant calls with request
Knowledgeable of policies, procedures and coverage of various funds
Assist callers with questions regarding deductibles, out of pocket accumulators, dental, vision and medical benefits, MRA or Bennycard and short-term disability inquiries
Status medical, dental and vision claims for members and some providers
Maintain records of all interactions with members/providers
Make outgoing calls to members, providers, collection agencies and vendors such as BCBSMI, HAP to resolve claim or eligibility issues
Follow up with members to ensure any issues are resolved
Request check tracers
Enter change of address notifications
Submit escalations to management for complex calls for assistance
Regular and predictable attendance is an essential function of this job
Qualification
Required
Excellent customer service skills are a must
Proficient in the use of Word, Outlook and Excel
Good oral and written communication skills
Ability to read and interpret eligibility rules as outlined in the SPD, user manuals for on-line services, department rules and procedures manual, COBRA Compliance manual
Ability to speak clearly and effectively explain to members, dependents, providers and union officials the month-to-month eligibility rules and requirements for coverage
General math skills with the ability to calculate hours and rates to determine self-payments and hour banks
Must be capable of thoroughly analyzing vendor invoices and all month-end reports, find discrepancies in member's eligibility, make necessary corrections based on department procedures, understand Plan rules and analysis of member's eligibility
Must be able to sit for up to eight hours each day answering incoming calls and preparing various correspondence using a variety of office equipment
Must be able to stand for one-to-three-hour intervals while completing filing tasks, organizing department fulfillment center, standing at copy machines to make packages
Must be able to move to different workstations as position needs warrant
Must be able to maintain composure with difficult callers
Must be able to multi-task
Must be detail oriented
Must be able to manage several projects at one time and may be interrupted frequently to meet the needs and requests of multiple clients
Preferred
Spanish speaking
Post-High School education or prior related work experience preferred
Benefits
12 paid holidays
Paid Time Off (PTO)
3 days paid bereavement
Up to 20 days paid jury leave
Medical, dental, and vision insurance, with option for dependent coverage
Company-paid basic life, short-term disability, long-term disability, and AD&D insurance
401k with employer match
Tuition reimbursement program
Career development opportunities
Referral bonus for all successful full-time referrals
Annual opportunities for increases
Company
BeneSys, Inc.
BeneSys is a team of dedicated Taft-Hartley Trust Fund Specialists. BeneSys understands the nuances of Taft-Hartley benefit plans.
Founded in 1979
501-1000 employees
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
Tenex Capital Management
2018-10-05Private Equity
2014-04-01Acquired
Leadership Team
Edward Wolyniec
CEO
Recent News
2025-08-29
Company data provided by crunchbase