Job Description

POSITION TITLE: Member Services Clerk I

DEPARTMENT: Member Services

FLSA: Non Exempt

REPORTS TO: Member Services Supervisor

DESCRIPTION

Provide benefit, claim & eligibility information in response to members' & providers' inquiries and when needed, create documentation to direct action for resolution and/or changes required to ensure accurate administration of those members' benefits.

SKILLS / KNOWLEDGE REQUIREMENTS

· Excellent Customer Service and Communication Skills

· Computer Literate in Word and Excel & other Microsoft applications

· 10 Key by Touch

· Type 45 WPM

· Good Communication Skills (written and verbal)

· Quick learner with the desire and initiative to keep learning

· Self-starter

· Strong organizational and multi-tasking skills

· Strong concentration, listening and problem-solving skills

· Some accounting experience, a plus

· Prefer minimum of 2 years college education or 4 years work experience in related field

DUTIES

· Access, interpret and analyze information maintained on computer databases and in resource manuals that requires effective use of keyboard and PC screens.

· Respond and follow-up to member/provider inquiries in a timely and professional manner. Communicate accurate membership, benefit and claims information in response to inquiries verbally or through written correspondence within established procedures. Elevate exceptional cases to supervisor.

· Knowledge of the benefits for designated Health & Welfare account(s).

· Identify specific questions, problems or concerns using clarifying questions and research of individual files when contact is initiated by member or provider on the phone.

· Create, log and track contacts that require further action and maintain pending file to follow-up resolution of inquiries.

· Update records & complete process for various Fund benefits as required daily. Such as Age 26 notifications, Handicapped Reports, Address changes, Enrollment form verification and process, Disability process, COBRA & Self-Pay process, Child support requests, COBRA monthly notices, Life insurance process, Eligible but not covered process.

· File various documents to each member's folder for accurate record keeping.

· Present all information in a manner that represents PAI favorably and professionally.

· Assist supervisor and/or manager with other duties or projects as needed.

OTHER DUTIES

· Receptionist Relief as needed and assigned

PHYSICAL DEMANDS

· Lifting and carrying file boxes within the office

WORKING CONDITIONS

· Indoors, air-conditioned office.

· Conditions will vary at client locations.

WORK SHIFT

· Monday to Friday, 8:00 AM – 4:00PM or 8:30 AM – 4:30 PM, 1 hour unpaid lunch

· The duties assigned will (may) involve situations that will (may) require over time

Company Description

Our Company and Mission Pacific Administrators, Inc. is a technology-driven third-party administrator in Hawaii that provides employee health and welfare, pension, annuity, and vacation benefit services for many local union members. We take pride in the fact that our company is locally owned and operated. Our company motto is 'Kulia I Ka Nu'u', which means 'Strive for the Highest' - best service, positive attitude, teamwork, training, attaining goals (personal, department, company), solving problems/learn/move forward. Our corporate mission is to be the industry leader in quality service to our valued customers. Our Corporate Culture We are a humble team of equals who have positive attitudes, treat everyone with respect and fairness, work together, have a strong ‘work ethic’, and who are dedicated to providing exceptional customer service. Our Core Values • Walk the Talk - Lead by example, listen, coach, train; always with respect. • Attitude of Gratitude - Value our employees, clients and service providers. • Do What it Takes - We are all accountable, relied upon and appreciated. • Kulia I Ka Nu'u - Service excellence to our customers, our participants, our service providers and one another. • Same Canoe - Our Helmsman steers our canoe and guides us forward. As a team, we are all: "paddling together" in sync, positive, considerate and communicative with one another.