Insurance Assistant 1 - Administration - PEIA - Kanawha Co
- Kanawha County, WV
- $37,440-41,600 per year
- Permanent
- Full-time
Join our team at PEIA! This position will assist members, providers and the general public via telephone, walk-in or correspondence concerning benefits and claims in the administration of the Public Employees Insurance Agency Benefits Program. This position will perform a variety of basic customer service work by answering inquiries, resolving complaints and explaining benefits, rules, regulations and agency policies. Must be knowledgeable about all benefits administered by the agency. May travel throughout the state. This position will perform work as required.Click The APPLY Link To Apply Online.IMPORTANT: You MUST complete ALL parts of the application, including the Work Experience section, or you may attach a detailed resume. Please make sure to review the “Other Information” section of this listing for any specific instructions of the hiring department.ATTENTION: Applicants may provide verification of post high school education by submitting an official transcript or diploma, training or licensure earned pertaining to this position by the closing date of the posting, if not previously verified. Protecting your personal information is our highest priority. If your official transcript, training/licensure, or Veterans documentation contains your Social Security Number and/or birthdate, please redact any personal information before submitting it to the Division of Personnel.Please attach documents to the online application before submitting it. Or, you may email it to: applicantservices@wv.gov or by U.S.mail to: WV Division of Personnel, 1900 Kanawha Blvd. E., Building 3, Suite 500, Charleston, WV 25305.Be sure to submit your application for each position of interest. To receive an email notification anytime jobs in this or other categories are posted, you may choose to complete a from the slide-out menu located at the top left of our Job Opportunities page.Examples of Work
- Answers written and verbal inquiries from members, retirees, providers, attorneys, Third Party Administrators, state and local government agencies, and the general public by explaining rules, regulations and agency policies.
- Works as a team player in diverse and professional in a call center environment to troubleshoot and isolate problems.
- Meet and achieve department standards for phone availability, logged in times, the quantity of calls taken and hold times.
- Process and document all transactions in administration systems and workflow processes.
- Resolves problem claims by interacting with claimants, payroll clerks, providers and insurance companies.
- Research appeals, communicating directly with health care and pharmacy providers.
- Communicates with contracted vendor representatives to obtain services and resolve conflicts.
- May participate in special projects that help support administration, customer service or agency units and work on special project teams that cross department li
- Prevent and defuse situations through research, problem solving, customer education, exploring alternative solutions and follow up to ensure a successful resolution.
- Build excellent customer relationships during every interaction, one call resolutions always being the goal
- Research billing issues and may follow-up on delinquent accounts
- Provides reports to management staff regarding daily activities, process improvements.
- Knowledge of the Public Employees Insurance Agency Benefit Program.
- Knowledge of Third Party Administrators policies, systems and operations.
- Knowledge of English grammar use and composition.
- Ability to explain benefit programs to members, providers and the general public.
- Ability to train employer benefit coordinators and PEIA employees in all areas of insurance eligibility, enrollment, data entry and termination of coverage
- Ability to interpret rules, regulations and policies.
- Ability to type accurately.
- Ability to establish and maintain good working relationships with members, providers, attorneys and the general public.
- Ability to communicate effectively, both orally and in writing.