Thank you for considering a career at Bon Secours Mercy Health!

SUMMARY

Performs operational duties to the Bon Secours Mercy Health System benefit and well-being plans. Researches, audits and ensures plan administration is consistently administered 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 HRTS system.

ESSENTIAL JOB FUNCTIONS

• Responds to 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 escalated benefits matters.
• Coordinates the appeal process for the health plans. Decision making process to determine the application of the appeal process to the situation. Makes necessary changes to plan based on the appeal approval and collecting arrears that are due or refunding premiums that were deducted.
• Managing processes to carriers of updates that will not get picked up on scheduled file feeds to ensure accurate and timely eligibility requirements in addition to report review, processing, and reporting.
• Manages audits and special projects related to the benefits plans. Identifies and escalates issues and process flaws with recommended solutions to HRTS Benefits and/or the Benefits Center of Excellence as needed.
• Serves as a SME for escalated issues from the Associate Service Center and leaders answering complex HR benefits related questions and/or clarifying eligibility.
• Decision making skills in the eligibility and enrollment process within the benefit plans.
• Prepares EIBs for benefit premium corrections, PTO/Leave payouts, dependent updates and ACA corrections.

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation.

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:

Min 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.

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:

Work Shift:

Department:

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 recruitment@mercy.com. 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 recruitment@mercy.com.