SUMMARY
The purpose of this position is to assist in the benefit application process by validating and entering sensitive data from beneficiary documents and other sources, logging applications, and assigning work to Benefits Specialists at the direction of the Manager. The Benefits Assistant handles basic applicant and beneficiary inquiries regarding health and pension benefit eligibility, maintenance of the electronic funds transfers of pension payments, and verification and updating of demographic data. The Benefits Assistant may handle follow-up tasks as delegated by the processing staff, requesting documents from applicants, coal companies, the UMWA or government agencies. This position also provides general administrative support for office activities while working collaboratively in a team environment.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:
Assists applicants in filling out applications and forms and explains the requirements of accompanying documentation. Compiles and logs all available data and documentation into a complete digital file for processing. Screens applications and supporting documents for completeness and correctness according to specified procedures.
Receives a large number of documents; completes an electronic checklist for the case. Analyzes an application to determine whether additional basic information is required. Prepares correspondence to request birth certificates, marriage certificates, and other application processing documentation. Returns incomplete applications for signatures. Calls applicants to confirm application information. Updates checklists with specific documents requested, sets pending codes, and adds processor follow-up dates. Prints and mails correspondence and provides Records Management with copies to scan to the imaged application file.
Reviews a mineworker’s complete coal industry employment history when logging new pension application forms. Analyzes signatory credit hours, coal company statements, union dues records, and the applicant’s claimed coal employment history to determine if a wage record should be requested. Completes a wage record request form spanning the appropriate employment period, mails to applicant for signature, and mails the returned document to the Social Security Administration (SSA). Logs the pension application to reflect the period of claimed coal employment. Adds system comment to document the period earnings were requested and the mailing date.
Assigns benefit applications and pension estimate requests to processing staff following the manager’s rotation schedule. Routes imaged documents and applications to assigned processor. Prioritizes the team’s workload to achieve appropriately quick turnaround times. Monitors status of application queue and updates manager if assistance is required to meet established logging turn-around times.
Tracks whether requested information and documentation has been received on a timely basis. Manages the follow-up process, using letters and phone calls to make second and subsequent attempts at collecting needed data and documentation. Follows up with SSA and advises manager if wage records are not received within the standard turnaround time.
Requests documentation from beneficiaries authorizing the exchange of Medicare eligibility data with the Center for Medicare and Medicaid Services (CMS).
Queries the CMS Medicare database to identify Medicare-eligible beneficiaries. Updates Funds’ eligibility database with CMS enrollment data to enroll appropriate individuals into the Funds’ Health Care Prepayment Plan.
Enters, updates and/or corrects beneficiary and payment information and records on computer database systems. Assists in maintenance of records and maintains and compiles statistical data as required. Updates federal tax withholding information and beneficiary addresses. Enters union dues check-off records into eligibility system, maintains records, and responds in writing to dues inquiries from union officials. Meets tight deadlines, especially when beneficiary and payment updates are received close to the cut-off date for creating monthly pension checks.
Enters requests for electronic funds transfers (EFT) into automated database and maintains a large database of bank account data for over a large number of payees. Contacts financial institutions to determine appropriate handling of direct deposits or status of checks. Handles all phases of EFT: enters data; researches, and resolves problems; updates the FMS system with the correct information; pre-notes and identifies payments to be reissued.
Compiles, reviews, and mails benefit award letters, including first-payment and stand-alone checks. Matches each beneficiary approval letter against a daily payment register. Follows up with manager if any payment cannot be mailed on the date payment is created. Ensures the secure storage of pension checks following established procedures. Maintains a supply of standard beneficiary mailing inserts and verifies that all required inserts are included with each mailing. Hand delivers all outgoing payments directly to mailroom staff.
Reviews General/Durable/Medical Power of Attorney, Guardianship, Conservatorship, and other representative documents for completeness. Enters, documents, and files or routes information in FMS as appropriate.
Communicates verbally and in writing with applicants, UMWA representatives, coal company representatives and local, state, and federal agencies on routine eligibility matters. Answers basic eligibility and benefits questions, directs inquiries to appropriate staff for more complex issues, and provides general information concerning Funds’ application process.
Processes returned beneficiary mail and checks. When mail is returned undeliverable, cancels returned checks, maintains detailed records, and follows detailed procedures to secure data and payments. When returned mail indicates that a beneficiary has moved, attempts to locate the beneficiary and requests written confirmation of their new address. Notifies manager if unable to locate beneficiaries so that benefits and payments may be suspended.
Monitors, researches, and resolves issues related to non-negotiated checks that have become stale dated.
Participates in recurring and nonrecurring special projects such as beneficiary questionnaires, TEFRA notices, 1099s, and 1095s, and Medicare correspondence mailing.
Types short letters and memos from handwritten drafts and other records.
Responsible for adhering to all Funds’ policies and procedures adopted to comply with the Health Insurance Portability and Accountability Act (HIPAA) governing the privacy, security, and use of protected health information.
Travels as required to conduct Funds’ business.
Assists with special projects and day-to-day activities.
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATION and/or EXPERIENCE
High school diploma or General Education Degree (GED) PLUS two years of prior experience working with a large number of people and/or documents and following complex policies and procedures.
TECHNICAL, BUSINESS, and INDUSTRY KNOWLEDGE
Demonstrated ability and willingness to efficiently use FMS or other web-based applications to collect information, generate reports, and manipulate data.
Demonstrated ability to operate office equipment including PC’s, copier machines, fax machines, printers, and scanners.
Must pass speeded typing test at minimum of 25 wpm with 5 or fewer errors. May be required to use spreadsheet applications such as Excel.
Must demonstrate the ability to communicate effectively by passing an oral test.
COMMUNICATION SKILLS
Basic – Ability to effectively present information in one-on-one and small group situations such as to beneficiaries and other Funds’ employees for the purpose of exchanging basic factual information and coordinating activities.
Basic – Ability to read and comprehend simple instructions, short correspondence, and manuals.
MATHEMATICAL SKILLS
Basic – Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent.
CERTIFICATES, LICENSES, REGISTRATIONS
None.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to sit; use hands to type, finger, handle, or feel; reach with hands and arms; and talk or hear. The employee frequently is required to stand and walk. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, and ability to adjust focus.
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The noise level in the work environment is usually moderate. During periods of travel, noise level may be variable.
PROBATIONARY PERIOD
90 standard workdays pursuant to Sections 5.06, 5.07, and 5.08 of the Collectively Bargained Agreement.
COMPLETE BACKGROUND CHECK REQUIRED.
Benefits:
401(k)
401(k) matching
Dental insurance
Employee assistance program
Flexible schedule
Flexible spending account
Health insurance
Life insurance
Paid time off
Parental leave
Professional development assistance
Retirement plan
Tuition reimbursement
Vision insurance