Group Processing Specialist 

Essential Responsibilities:

1. Review and prepare new group materials, group change requests, new group member applications, and renewal changes for small fully insured groups, for imaging in OnBase application.
2. Coordinate and confirm benefits and eligibility variations on groups as required. Coordinate with staff to analyze and create new products or plan materials, as needed.
3. Review group master applications, forms, proposal requests, and correspondence. Follow up with sales staff for missing information.
4. Analyze new group structure, billing, and reporting requirements. Enter group data into Facets and PSE.
5. Validate product codes, financial codes, and other related codes for groups and subgroups. Determine if new product is needed to support rating and coordinate with the Facets Business Support Department as needed.
6. Create and distribute plan materials in accordance with current workflow processes.
7. Process all group demographic changes.
8. Generate census and cross-reference member information on master application with final proposal census.
9. Upload final premium rates based on actual enrollment for new groups, or rates calculated at renewal.
10. Track group processing status in PSE and enter group notes in Facets.
11. Verify appointed agent/producer and enter data in Facets.
12. Develop and update procedures and job aids as needed.

Supporting Responsibilities:

1. Meet department and company performance and attendance expectations.
2. Participate in LEAN Board daily huddle, team and department meetings, mentor training, and team building activities.
3. Follow the privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
4. Perform other duties as assigned.