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