Temporary Benefits Administrative Coordinator

Acara Solutions is looking for a remote Temporary Benefits Administrative Coordinator for one of our clients in the health insurance industry.

• Pay rate: $22.00/Hour.
• Hours: 40 Hours/Week 8:00-4:30 pm, Monday - Friday
• Length: Temp (6 Months)
• Fully remote- must be in WNY area

Here's what you'd do:

• The Appeals Operations Coordinator shall be responsible for coordinating communication documents (including correspondence) to the client stakeholders (internal and external) to ensure that all communications and supporting documentation are written and distributed appropriately and in compliance with all regulatory requirements.
• Appeals and complaints are received through various methods and must be managed in a highly efficient manner, with acute attention to detail and the use of critical thinking.
• All work handled by the Appeals Operations Coordinator involves highly regulated policies that directly impact the client performance, including but not limited to regulatory and quality audits that affect star ratings and civil monetary penalties.
• The operations coordinator is responsible for preparing all complaints received through internal or external means.
• In addition, the Appeals Operations Coordinator will be responsible for overseeing the appeals process, including all duties related to the appeals committee meetings, to ensure the timely execution of all regulatory functions.
• The Appeals Operations Coordinator will also assist in preparing the benefit administration staff to support all initiatives, including documenting information received in various team meetings.
• Ensure thorough research is conducted to verify that all necessary information has been received.
• This includes, but is not limited to, researching valid Health Insurance Portability and Accountability Act (HIPAA), Authorization of Release (AOR), and Worker's Own Liability (WOL) forms in the system, researching previous appeals in the system, and determining that the necessary information has been provided from external documentation received.
• Responsible for ensuring verbal and written correspondence regarding appeals, complaints, and regulatory investigations comply with regulatory standards, and work is prioritized based on expediency.
• Ensuring that all outgoing communications are Health Insurance Portability and Accountability Act (HIPAA) compliant and sent to the correct parties.
• Coordinate and complete work unit administrative requests, including appeal effectuations, by prioritizing and monitoring requests to ensure timely turnaround.
• Participate in Appeals Committee meetings, managing the logistics, taking and distributing minutes, and following up on any outstanding items as needed.
• Update and maintain the department record retention document(s).
• Creating communication documents and letters to external client customers in accordance with the departmental processes and regulations.
• This includes, but is not limited to, requesting medical records, invoices, and acknowledgement letters, as well as facilitating the payment of consultant invoices.
• Perform outreach calls as needed to a defined audience (members, physicians, employers, and regulatory agencies) to follow up on requests for information.
• Responsible for assisting in meeting department goals and objectives and identifying process improvements to improve member/provider satisfaction continuously.
• Attend assigned meetings as the department representative and report to team members as needed.
• Other duties as needed.

About Acara Solutions

Acara is a premier provider of recruiting and workforce solutions, and we help companies compete for talent. With a legacy of needs in various industries worldwide, we partner with clients, listen to them, and customize visionary talent solutions that drive desired business outcomes. We leverage decades of experience to deliver contingent staffing, direct placement, executive search, and workforce services worldwide.

• High School Diploma or GED
• Minimum of 3 years of experience in communication or customer service roles, particularly in a healthcare setting.
• Minimum of 3 years of experience in appeals processing or regulatory compliance.

• Associate's Degree.
• Minimum of 2 years of administrative/customer service experience.
• Excellent time management and organizational skills needed with acute attention to detail and the use of critical thinking
• Be proficient at the advanced level in the Microsoft Office suite, particularly Word, Excel, and PowerPoint.
• Demonstrates a competent and courteous telephone manner and practical customer service skills.
• Prioritization skills to ensure all work is completed and meets regulatory timeframes.
• Excellent follow-up/follow-through skills.
• Demonstrated ability to work in a fast-paced, ever-changing environment.
• Proven ability to communicate precise and understandable information in written form based on the targeted audience.
• Excellent proof-reading skills.
• Ability to work independently.
• Adapt and respond to all regulatory requirements.
• The ability to telecommute (work remotely off-campus) as needed on a regular basis or whenever necessary to continue business operations.

Additional Information :

• Upon offer of employment, the individual will be subject to a background check and a drug screen.
• In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification form upon hire.
• Work is typically performed in an office environment with some physical demands such as: sitting for long periods of time (6-8 hours per day) bending, stretching, lifting, typing, speaking, hearing, handling, fingering, lifting up to 5 lbs., near acuity/clarity with or without correction, subject to inside environmental conditions but not necessarily from temperature changes, subject to moderate noise, and normal exposure to everyday risks and discomfort requiring common safety precautions.
• While performing the duties of this job, the associate is regularly needed to communicate professionally in person, over the telephone, through email, and other electronic means, handle various types of media and equipment, and visually or otherwise identify, observe, and assess.
• Responsibilities may occasionally require an adjusted work schedule, including overtime and evening hours, to meet deadlines.
• Maintains confidentiality and uses only the minimum amount of protected health information (PHI) necessary to accomplish job-related responsibilities.
• Other duties as needed.