Insurance Operations Specialist

Renaissance Benefits is seeking an Operations Support Specialist to join our growing team here in Indianapolis, IN!

At Renaissance the Operations Support Specialist is responsible for the installation of new products, the development of customer fulfillment materials, renewals, enrollment entry, enrollment reconciliation, accuracy of premiums and billing, addressing/responding to customer escalations, addressing/responding to audits (internal, DOI and CMS) and the development/maintenance of SOP’s.

What will this role entail?

• Installation of new products Includes: Accurately build plans in the systems. Participate in system testing. Coordinate and obtain business unit signoffs. Create policies and summaries for distribution to the subscriber. Coordinate with vendors (vision, doc generation) for their builds and QC accuracy.
• Renewals Includes: Work with the business and TPA’s to obtain renewal letters and rates. Test accuracy of renewal letters. Coordinate and execute ticket process for DDMI activities. Manage/build matrices required to ensure the correct letters are distributed to the correct subscribers. Coordinate and obtain business unit signoffs. Build new plans/update current plans as benefits change. Create/revise policies and summaries for distribution to the subscriber. Coordinate with vendors (vision, doc generation) for their builds and QC accuracy. Run eligibility reports and validate appropriate plan changes have been made at the time of renewal.
• Enrollment Includes: Entry of manual enrollments including the set-up of payment preference. 834 file acceptance. Electronic file reconciliation and resolution; communicating with sender regarding issues. Resolution of enrollment issues communicated by state and federal entities. Submission of disputes regarding enrollment.
• Premium & Billing Includes: Validation of premium payment pulls. Work with Cash Applications to analyze and request under/overpayments be processed.
• Customer Escalations Includes: Resolution of Service requests submitted by Customer Service. Request fulfilment materials be generated. Resolution of customer issues communicated via TPA’s.
• Audits Include: Work with Compliance to respond to internal and DOI audits. Investigate potential issues/questions and provide feedback for response.
• Development/Maintenance of SOP’s Includes: Develop SOP’s for new procedures and or systems. Ensure SOP’s are maintained and updated through the performance of an annual review.
• Participate in calls with TPA’s and customer partners to ensure understanding of accurate coding and any potential deadlines or policy changes.
• Perform other activities as necessary and required to support the Individual Operations team.

What must I possess to qualify?

• Position requires Associates Degree and/or four years of experience working in Individual Markets including Federal Marketplace or related field
• Requires demonstrable experience in Microsoft Word and Excel
• Excellent verbal and written communication skills
• Strong customer service skills
• Knowledge of dental terminology and dental procedures are helpful

Pay: $18.00 - $22.00 per hour

Benefits:

• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Contract type:

• Permanent

Weekly day range:

• Monday to Friday

Work setting:

• In-person
• Office

Education:

• High school or equivalent (Required)

Experience:

• insurance: 2 years (Preferred)
• operations: 1 year (Preferred)

Work Location: In person