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Group Services Rep II

Company: Sonrava Health
Location: Orange
Posted on: May 24, 2023

Job Description:

Overview:This position is responsible for performing all daily duties pertaining to new and existing groups and individual Plans.Responsibilities:

  • Answering inbound telephone calls from brokers/agents, existing clients, potential clients. Providing backup for provider and member calls.
  • Process member additions, terminations or changes (Manually and Electronic Files)
  • Provide eligibility information to the Plan Department and Provider Services (this may include calling or email group to confirm members eligibility).
  • Run Monthly billing for all groups, once a month
  • Account reconciliation (Retro-credits, new dues and disbursements).
  • Mail monthly client invoices.
  • Process daily bank deposit.
  • Resolve account discrepancies by investigating documentation of previous payments and adjustments.
  • Prepare Schedule As (Form 5500) for groups.
  • Process check requests for plan refunds, capitation, commission or account discrepancies.
  • Create new group profiles.
  • Send Intent to Terminate letters to groups and members that are in jeopardy due to lack of payment and process accounts terminations.
  • Send letters to over the age dependents regarding their coverage.
  • Update Groups monthly renewal information according to Rate Advisory Worksheet.
  • Generate ID cards (csv file is generated for third party printing company once per week).
  • EFT processing
  • Monthly review of account receivable and financial books
  • Review, track and administer major groups
  • Interact with other departments (or areas) to resolve patient, group, broker or provider inquiries.
  • Assist in training new staff in the Group Services Department.
  • Process payments and refunds for Web Plan
  • Filing and other clerical duties as assigned.
  • Produce monthly renewal reports for Individual and Web Plan members
  • Assist web plan members with renewing process.Qualifications:
    • High School diploma and min. two years Customer Service or insurance industry experience
    • Excellent oral and written communication skills
    • Proficient in Microsoft Word and Excel
    • General Math Skills

Keywords: Sonrava Health, Orange , Group Services Rep II, Sales , Orange, California

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