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Thank you for considering a career at Bon Secours Mercy Health!
Summary
Provides administrative support to the Bon Secours Mercy Health System benefits plans. Researches, audits and ensures plan administration is consistently managed based on plan design. Communicates with a variety of contacts and answers questions about the Bon Secours Mercy Health plans. Determines employee eligibility and maintains data administration in HRIS system.
Essential Job Functions
Manages claims escalation and resolution with vendors. To include confirmation of coverage with vendor, confirmation on how claim was paid (includes claim access to vendor system), determines was claim paid in accordance with Plan design, and confirmation of network participation.
Provides information on the Bon Secours Mercy Health benefit programs to employees and assists explaining benefits and resolving benefits matters.
Manages the appeal process for the health plans. Makes necessary changes to plan based on the appeal approval and collecting arrears that are due or refunding premiums that were deducted.
Manages Accountable Care Act (ACA) monthly new hire enrollment process. Send notice to those that are currently benefit ineligible that are now eligible under the rules of ACA and initial measurement period. Handles changes for those no longer eligible as needed.
Send notifications to carriers of updates that will not get picked up on scheduled file feeds to ensure accurate and timely eligibility requirements.
Completes audits and special projects related to the benefits plans.
Reviews dependent eligibility to ensure alignment with plan design.
Performs research required for benefit plan administration.
Serves as a resource for escalated issues from the Associate Service Center and leaders answering complex HR benefits related questions and/or clarifying eligibility.
Other special projects as assigned.
Qualifications
Required Minimum Education:
4 year/ Bachelors Degree
Specialty/Major- Human Resources Administration or similar experience
Combination of post-secondary education and experience in lieu of a degree.
Minimum Years and Type of Experience:
Minimum 2 years’ experience working with company sponsored benefits plans.
Other Knowledge, Skills and Abilities Required:
Work requires the ability to communicate and respond to a wide variety of individuals and questions both orally and in writing. Requires demonstrated ability to exercise judgment, take initiative, prioritize work, meet non-negotiable timeframes, and attend to detail in a time-pressured, high volume work environment. Strong written and oral communications, organizational, and attention to detail skills. Knowledge of Microsoft operating systems and Microsoft Office suite. Ability to work in a fast-paced team environment, handle multiple tasks, and prioritize work. Demonstrated ability to work collaboratively with staff and others for problem resolution. Work requires a high level of accuracy with the ability to concentrate on detailed information for extended periods of time. Work requires following established confidentiality guidelines at all times.
Other Knowledge, Skills and Abilities Preferred:
A working knowledge of HR operations and benefits administration is preferred. The incumbent is expected to gain a full understanding of all local system and standard Benefits within the first 6 months, according to policy and practice documentation. Significant PC experience, such as Microsoft Word, Outlook, Excel, Service Now and Workday preferred.
WORKING CONDITIONS
_x_ Periods of high stress and fluctuating workloads may occur.
___ Long-distance or air travel as needed- not to exceed 10% travel.
_x_ General office environment.
___ May be exposed to high noise levels and bright lights.
___ May be exposed to physical altercations and verbal abuse.
___ May be exposed to limited hazardous substances or body fluids.*
___ May be required to use physical restraints.
___ May be exposed to human blood and other potentially infectious materials.*
___ May be exposed to adverse weather conditions; cold, hot, dust, wind, etc.
___ May have periods of constant interruptions.
___ Required to car travel to off-site locations, occasionally in adverse weather conditions.
___ Prolonged periods of working alone.
Bon Secours Mercy Health is an equal opportunity employer.
Many of our opportunities reward* your hard work with:
Comprehensive, affordable medical, dental and vision plans
Prescription drug coverage
Flexible spending accounts
Life insurance w/AD&D
Employer contributions to retirement savings plan when eligible
Paid time off
Educational Assistance
And much more
- Benefits offerings vary according to employment status
Scheduled Weekly Hours:
40
Work Shift:
Days
Department:
SS Human Resources – HR Services
All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you’d like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email [email protected]. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at [email protected].
