Benefit Analyst

Overview

OVERVIEW:

A MESSA benefit analyst provides direct customer/member service in a call center environment. Paid training is provided.

BASIC PERFORMANCE EXPECTATIONS:

This position requires a pro-active person who thrives in a team environment. The incumbent enjoys planning and guiding others through complex situations. A successful candidate is a keen problem-solver who can think on their feet.

This position requires a commitment to providing unmatched service to the hardworking members who care for our children, schools and communities. This position will assist customers and members who have questions about their MESSA coverage, provide general information, handle complaints and troubleshoot customer service problems.

A requirement for this position is to review, calculate and determine claims for health, vision and dental benefits based on benefit payment rules, coordination of benefit rules and other guidelines.

A hands on training will be provided that includes plan information, payment rules, medical terminology, processes, workflows, technology and more.

A successful incumbent will adapt well to change and be comfortable talking with members, providers, coworkers and managers and assist them as needed.

ASSIGNED DUTIES:

Take and make frequent telephone calls.

Handle sensitive personal and health information and follow established guidelines for confidentiality and privacy.

Evaluate and use sound judgement to make decisions about claims.

Handle payments in an accurate and timely manner.

Identify and escalate issues to supervisors.

Route calls to appropriate resources.

Make follow-up customer/member calls where necessary.

Perform other job related duties as assigned from time to time.

MINIMUM REQUIREMENTS:

Graduation from a standard high school or vocational school.

Experience and training which provide the following abilities, skills and knowledge;

ability to operate a personal computer and common office equipment;

ability to make decisions and to work with speed and accuracy;

skill in composing accurate correspondence;

ability to successfully complete MESSA Benefit Analyst training program;

·         superior listening, verbal and written communication skills;

·         ability to handle stressful situation appropriately.