Welfare Dependent & Beneficiary Associate

Description

Position Overview 

The Dependent and Beneficiary Associate is responsible for administering dependent eligibility and beneficiary enrollment processes for the Welfare Fund. This role ensures accurate maintenance of participant records, reviews supporting documentation, processes status changes, supports Qualified Medical Child Support Order (QMCSO) administration, and assists with audits, retroactive terminations, and related member communications. 

The role requires strong attention to detail, sound administrative judgment, professionalism, confidentiality, and excellent member service skills in a fast-paced benefits administration environment.

Essential Job Functions 

• Reviews and verifies documentation supporting dependent eligibility and beneficiary designations. 
• Accurately enters, updates, and maintains dependent and beneficiary information within the Fund’s administration systems. 
• Processes dependent status changes resulting from marriage, divorce, legal separation, death, aging out, or other qualifying events. 
• Reviews records for completeness and accuracy and escalates unusual findings or discrepancies to management. Scans, indexes, and maintains electronic records and correspondence in accordance with departmental procedures. 
• Communicates with members, attorneys, agencies, healthcare providers, and other parties regarding eligibility documentation and related matters. 
•  Assists with the administration of Qualified Medical Child Support Orders (QMCSOs). 
• Supports claim audit reviews related to retroactive terminations and eligibility changes. 
• Prepares and maintains member communications and documentation regarding claim overpayments and retroactive eligibility adjustments. 
• Maintains confidentiality of participant information in accordance with HIPAA and applicable federal and state regulations. 
•  Utilizes departmental systems and software applications efficiently and accurately. 
• Participates in departmental cross-training initiatives and workflow support activities.
•  Assists with special projects and operational initiatives as assigned. 
• Meets departmental productivity, accuracy, and turnaround expectations.

Requirements

• Bachelor’s degree required. 
• Minimum of 2 years of administrative, eligibility, claims, or benefits-related experience preferred. 
• Experience handling confidential information and maintaining records with a high degree of accuracy. 

Skills and Competencies

• Strong written, verbal, and interpersonal communication skills. 
• Excellent organizational skills with strong attention to detail and accuracy. 
• Ability to prioritize multiple assignments and meet deadlines in a fast-paced environment. 
• Strong analytical and problem-solving abilities. 
• Ability to exercise sound judgment and identify issues requiring escalation. 
• Ability to work independently as well as collaboratively within a team environment. 
• Professional and member-service-oriented demeanor. 
• Proficient in Microsoft Word, Excel, Outlook, and database management systems. 

Work Environment 

• Primarily office-based position requiring prolonged computer and telephone use. 
• Ability to manage multiple priorities and maintain focus in a deadline-driven environment. 
• Regular attendance and punctuality are essential functions of the position. 

Salary and Benefits 

Salary: $65,000

The rate of pay offered will be based on relevant skills, education, experience, and qualifications. The NYCDCC Benefit Funds offer a comprehensive and competitive benefits package, including 100% employer-paid health benefits, an employer-funded annuity contribution equal to 10% of compensation, paid time off, and professional-development support, including CEBS and continuing-education programs.

 EEO Statement

The NYCDCC Benefit Funds are committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of race, creed, religion, color, national origin, ancestry, alienage, pregnancy, disability, age, uniform service member status, veteran status, marital status, caregiver status, familial status, status as a victim of domestic violence, sexual violence or stalking, membership in a domestic partnership, sex, gender (including gender identity, gender expression or status as a transgender person), genetic information, sexual orientation (including an individual’s actual or perceived romantic, physical or sexual attraction to other persons, or lack thereof, on the basis of gender), sexual and reproductive health decisions, or on any other characteristic protected by applicable federal, state, or local law. If reasonable accommodation is needed to participate in the job application or interview process, please contact Krystal Higgins at (212) 366-7516.