Long Term Care Policy Administration Specialist I/II/III (Rochester) (Finance)

Job Description:

Summary:

Under the guidance of the Manager LTC Policy Administration, the LTC Policy Administration Specialist performs timely and accurate data-entry and transactional processing in the administration system. The incumbent processes coverage, demographic, and billing changes, and processes billing and collections, and commissions.

Essential Primary Responsibilities/Accountabilities:

All Levels:

• In accordance with established departmental procedures, corporate policies, member contracts and riders, will process, enter, modify insurance policies and information, payments, and request additional information needed, send correspondence when necessary and work closely with other required internal departments.
• Follows the appropriate procedures to balance daily cash receipts, and/or research cash records according to transaction type. Initiates the necessary actions to balance daily cash records.
• Researches and interprets premium and non-premium cash records associated with Wise database and pro-codes accordingly.
• Sorts incoming mail, scans and indexes all incoming and outgoing correspondences from the LTC Administrative and Benefits Department using the digital record retention system.
• Performs accurate, timely data-entry and transactional processing of benefit changes, terminations, waiver of premium, demographic changes and responds to insureds with appropriate correspondence.
• Reviews and verifies premium payments received electronically and physically, accepts, rejects, or processes insufficient funds, and prepares for deposit or processing according to administrative departmental procedure.
• Participates in the training needed to learn regulations, systems, procedures, develop skills and initiate actions to accurately fulfill all requirements of the job.
• Ensures compliance in meeting or exceeding the Company production standards for time service and quality.
• Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs.
• Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
• Regular and reliable attendance is expected and required.
• Performs other functions as assigned by management.

Level II:

• Duties are performed under limited supervision
• Resolves moderately complex administrative system transactions and cash reporting

Level III:

• Performs complex administrative system transactions and policy interpretation under very limited supervision.
• Trains other staff members as needed.
• Initiates involvement for higher level responsibilities or proactively volunteers for assisting in the resolution of escalated or systemic issues.

Minimum Qualifications:

Note of Classification: We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities.

All Levels:

• Associates degree in Business Administration, Health Care Administration, Health Economics or related field or 1 year of transaction processing or customer service experience required; preferably in a health care environment.
• Thorough working knowledge of the administrative system transactional processes and business workflow to handle all aspects of administrative procedures.
• Ability to efficiently resolve simple administrative transactions, through navigating screens on the computer, referencing written policies and procedures and adhering to the most current business requirements.
• Excellent communication skills and demonstrated abilities in dealing effectively with all levels of internal and external customers.
• Demonstrated ability to identify the root cause and trends of the systemic problem in order to recommend and then implement solutions.
• Must be able to work independently with a high level of accuracy.
• Self-directed and dependable.
• Assigned tasks / duties performed under the guidance of supervisor.
• Attends all training required to become proficient in position.
• Basic computer skills required, including the ability to navigate in a Windows environment. Ability to work between multiple programs and applications at the same time.
• Ability to meet or exceed reasonable expectations for quality, proficiency and production.
• Good verbal and written communication, organizational, reasoning and problem-solving skills.
• Ability to work effectively as a part of a team.
• Organizational skills.

Level II (In addition to Level I qualifications):

• Minimum of 12 months experience in a Level I Specialist or equivalent position.
• Adept at multi-tasking in order to efficiently resolve moderately complex administrative transactions and cash balancing reports.
• Strong organizational skills and ability to prioritize, multitask, and work in fast paced environment and remain professional and focused under multiple pressures and demands.
• Demonstrates solid results in behaviors, adheres to departmental guidelines, and demonstrates sound judgment in decision making.
• Demonstrated ability to perform all generally assigned specialized job tasks, with limited assistance, within the specialized units.

Level III (In addition to Level II qualifications):

• A minimum of one year's experience in the Level II Specialist or equivalent position.
• Highly Skilled at multi-tasking to efficiently resolve a wide variety of complex administrative transactions and cash balancing reports.
• Proficient in computer navigation. Very adept at working between multiple programs and applications at the same time.
• Communicating effectively and diplomatically and leading others as this is a demonstrated strength.
• Highly skilled and well-developed reasoning and problem-solving skills.
• Is seen as a subject matter expert and go-to resource by others.
• May be used to mentor and train others.
• Self-directed and dependable.

Physical Requirements:

• Work is completed in a normal office environment under fluorescent lighting.
• Ability to use a headset to listen to customer conversations required.
• Must be able to function while sitting at a desk viewing a computer and using a keyboard and mouse for 3 or more hours at a time.

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The Lifetime Healthcare Companies aims to attract the best talent from diverse socioeconomic, cultural and experiential backgrounds, to diversify our workforce and best reflect the communities we serve.

Our mission is to foster an environment where diversity and inclusion are explicitly recognized as fundamental parts of our organizational culture. We believe that diversity of thought and background drives innovation which enables us to provide leading-edge healthcare insurance and services. With that mission in mind, we recruit the best candidates from all communities, to diversify and strengthen our workforce.

OUR COMPANY CULTURE:

Employees are united by our Lifetime Way Values & Behaviors that include compassion, pride, excellence, innovation and having fun! We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits.

In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.

Equal Opportunity Employer

Compensation Range(s):

Level I: Grade N2: Minimum $18.22 - Maximum $23.89

Level II: Grade N3: Minimum $18.55 - Maximum $26.90

Level III: Grade N4: Minimum $19.22 - Maximum $30.76

The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position's minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays.

Please note: There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case-by-case basis.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.