Quality Control Reviewer II

Job description

Responsibilities: - Research and determine COBRA eligibility for members, spouses, and dependents of the 1199SEIU Benefit & Pension Funds - Review and process COBRA benefits via the eligibility and enrollment system (V3) - Communicate with members and other professionals via telephone or written correspondence regarding COBRA eligibility and COBRA benefit related issues - Assist Member Service Front Window staff with COBRA member inquiries - Process COBRA election forms and create invoices based on eligibility and billing to members including - processing of refunds and adjustments - Import payments to COBRA payment application to update coverage - Create prescription (RX) record and maintain eligibility according to COBRA payments - Identify trends and work with various departments to troubleshoot issues - Perform additional duties and projects as assigned by management - Research member’s record and forward information to various internal/external areas for update of coverage and creation of COBRA application if required - Investigate and process COBRA adjustments and/or refunds based on eligibility review Qualifications: - High School Diploma or GED required, some College or Deg...