COBRA Carrier Eligibility Specialist (remote)

NFP Corp.

Location: Northampton, Massachusetts

Job Type: Full time

Posted


Who We Are

NFP is a seven-time Best Places to Work award winner in Business Insurance who has also earned the 5-Star Diversity, Equity and Inclusion (DEI) award from Insurance Business magazine and the WORK180 employer endorsement. We’re a recognized Elite Agency award winner and a leading property and casualty broker, benefits consultant, wealth manager, and retirement plan advisor. NFP provides solutions enabling client success through the expertise of over 7,000 global employees, investments in innovative technologies, and enduring relationships with highly rated insurers, vendors and financial institutions. To learn more, please visit: https://www.NFP.com.

The Division within NFP

American Benefits Group (ABG) is one of the nation’s leading employee benefit solution providers for Consumer Directed Health accounts, COBRA and Direct Billing services. Over the course of the past 25 years, we have grown considerably and we are looking to grow our team even further. We are transforming the benefits administration industry with empowering technology and a world-class customer service experience. Come join us and be a part of a team of outstanding individuals working towards building benefit solutions and creating great futures.

This is a full-time position, working remotely. Because you will work with members, carriers and brokers in various US time zones, we are flexible on your location and work hours (within our discretion). We do require you to have experience with COBRA administration and/or COBRA call center functions.

Position Summary – COBRA Carrier Eligibility Specialist

The COBRA Carrier Eligibility Specialist plays a key role in managing the relationships with insurance carriers as well as clients and brokers, ensuring a timely processing of enrollment changes for COBRA participants and supporting quick resolutions to urgent changes. Working closely with other Specialists on the team, this role includes a multi-faceted range of responsibilities focused on all aspects of managing time-sensitive COBRA enrollment changes directly impacting the wellbeing of the participants we serve.

This position includes but is not limited to the following:

Carrier Notification Processing

  • Become an expert in the WEX Health COBRA carrier notifications
  • Collaborate with the night processing team to resolve problems from daily processing and communicate effectively, responding promptly to any questions
  • Thoroughly understand carrier notification generation and timing, while maintaining accurate records of carrier notification contacts
  • Serve as a reliable resource for internal inquiries and collaborate with clients and brokers to understand the service
  • Accurately document interactions in member records, promptly file completed emails, and appropriately escalate ongoing issues to management

Carrier Audits

  • Review and compare reports from carriers against our system for accuracy
  • Document discrepancies accurately and report them to relevant parties
  • Thoroughly research discrepancies, providing supporting documentation for resolution. Additionally, track discrepancies until resolution and proactively identify when audits may be necessary. Notify leadership promptly of escalated items or mistakes

Carrier Setups

  • Collaborate and communicate clearly with night processing team on ongoing carrier setups
  • Take timely action on escalated items that hinder carrier setup progress and regularly follow up with carriers until the process is established.
  • Stay current with processing guidelines within insurance carrier systems and maintain accurate processing instructions and logins for carrier portals.
  • Accurately curate client documents, including account structures, and maintain timely and accurate carrier setup status in our proprietary system
  • Notify Accounting promptly to commence invoicing and inform the Client/Broker and relevant parties of the status of carrier setup and completion
  • Maintain accurate account structures and contact information in client documents, updating them as needed throughout the year and at renewal

Urgent Reinstatements

  • Daily monitor and promptly act on newly added urgent reinstatement requests from the team while effectively prioritizing escalated urgent and access-to-care requests
  • Gracefully handle and appropriately prioritize sensitive requests, diligently following up on items lacking a response
  • Promptly handle care requests, update the tracker from email responses, and manage multiple urgent tasks efficiently
  • Communicate complex issues clearly and simply, escalate items appropriately, and ensure privacy by adhering to security and HIPAA guidelines

First-Class Customer Service

  • Provide exceptional customer service to all stakeholders, coordinate and attend calls as needed, and serve as a backup for customer service communications.
  • Ensure timely response to all requests from clients and brokers within one business day, with flexibility for permissible extensions.

General Responsibilities

  • Manages time and resources independently, thrives in time-sensitive situations, proactively identifies and solves issues, and implements process changes.
  • Communicates complex issues clearly, regularly assesses and improves processes, maintains accurate SOPs, and ensures data safety.
  • Engages productively with team members, actively participates in meetings, embodies core values, and shows initiative to stay updated with compliance changes.
  • Performs additional duties as requested by management, regularly meets with them to discuss process improvements and goals.
  • Maintains a positive team environment, remains engaged with compliance changes, and ensures the safety of client and participant data.

Qualifications and Experience

  • Have the ability to work remotely without interruptions during work hours, with the requirement to maintain a confidential workspace for protected data. Company equipment will be provided, and you are responsible for maintaining high-speed internet and other related utilities
  • Minimum 1 year experience in COBRA Administration required
  • 1-3 years of experience in WEX Health COBRA Administration Platform STRONGLY preferred
  • Experience in COBRA eligibility and enrollment processing preferred, but not required
  • Possesses excellent communication skills, with the ability to simplify complex sensitive information, a proven track record as an enthusiastic team player who can prioritize and multi-task under pressure, and a passion for making customers and coworkers feel valued and important.
  • Excellent PC Skills (Microsoft Office, Excel, Outlook, Teams, Sharepoint, Word)

NFP is proud to offer a competitive salary, PTO & paid holidays, 401(k) with match, exclusive discount programs, health & wellness programs, and more. Our PeopleFirst culture focuses on building and nurturing lifelong relationships with our employees because, at the end of the day, we exist to be there for others.

NFP and You... Better. Together.

NFP is an inclusive Equal Employment Opportunity employer