Quality Assurance & COBRA Representative

UNITE HERE HEALTH serves 200,000+ workers and their families in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity!

The QA and COBRA Representative will oversee all aspects of Consolidated Omnibus Budget Reconciliation Act (COBRA) administration, including processing notices, applications, payments, and reporting. This position will process Qualified Medical Child Support Orders (QMCSO) by assessing the validity of the orders, responding to the agencies timely, adding dependents, and tracking eligibility. This role will also serve as an independent unbiased capacity outside of the Operations Teams to assist with long-term objective employee auditing ensuring that quality is maintained, and that we identify knowledge gaps, and reinforce consistency of Contribution Accounting & Enrollment processes.

ESSENTIAL JOB FUNCTIONS AND DUTIES

COBRA/QMCSO:

• Processes COBRA continuation paperwork for COBRA qualified benefits, issue monthly premium invoices, process monthly payments for COBRA participants; as well as ongoing account maintenance.
• Issue COBRA elections paperwork in compliance with DOL requirements and deadlines (within 14 calendar days)
• Reviews weekly and monthly COBRA eligibility list for accuracy of qualifying events
• Generates and issues manual COBRA continuation paperwork upon request
• Performs internal and external customer service activities related to the administration of COBRA and QMSCO
• Interacts with internal and external customers (employers, Local Unions, participants, other Fund departments, etc.) to resolve complex issues related to administration of COBRA
• Independently responds to questions and emails sent to the COBRA email address within standard turnaround time
• Reports inconsistencies in eligibility, plan structure, account set-ups and systems structure to leadership
• Maintains data integrity within COBRA module and Quality Assurance Database for tracking, reporting, and analyzing
• Updates systems to track compliance and ensure that coverage is provided in accordance with the terms of the QMCSO
• Reviews the QMCSO eligibility list for accuracy of information and eligibility
• Research COBRA and QMSCO returned mail and updates information in systems

Quality:

• Conducts quality assessments and objectively audits the Contributions & Enrollment Representatives’ accounts via standardized forms and electronic feedback which would highlight areas where training and development are needed as well as areas of expertise
• Collaborate with other Quality Assurance and Training Support team members to identify training and development opportunities
• Analyze and identify trends and provide insight to leadership to reduce errors and improve Contributions & Enrollment processes and departmental performance
• Oversee the development of reporting and other data analytics to support the Quality program and supports idea to improve practices and consistency therein

Training:

• Collaborate with other Quality Assurance and Training Support team members to identify training and development opportunities.
• Participates in ad hoc training and serves as a backup trainer, as needed
• Assist with the creation of BLC training videos on identified topics related to training.

Process Improvement/Procedure Writing:

• Identify and document internal and external departmental processes improvement and procedure development
• Analyze current processes and workflows for process improvement. Include automated solutions, documentation and testing
• Demonstrates the Fund’s Diversity and Inclusion (D&I) principles in their conduct at work and contributes to a safe inclusive culture with equitable opportunities for success and career growth

ESSENTIAL QUALIFICATIONS

• 2 ~ 3 years of direct experience minimum with health benefits: audit and billing procedures, reconciliation of payments, eligibility rules including dependent coverage, COBRA and HIPAA Regulations, and customer service
• Working knowledge and experience in administration of COBRA preferred
• Working knowledge and experience with handling evaluation of workforce development needs preferred
• High school education, minimally, college education preferred  

Salary range for this position: Hourly $27.74 - $33.95. Actual base salary may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location.

Work Schedule (may vary to meet business needs): Monday~Friday, 7.5 hours per day (37.5 hours per week) as a hybrid work-from-home arrangement

We reward great work with great benefits, including but not limited to: Medical, Dental, Vision, Paid Time-Off (PTO), Paid Holidays, 401(k), Pension, Short- & Long-term Disability, Life, AD&D, Flexible Spending Accounts (healthcare & dependent care), Commuter Transit, Tuition Assistance, and Employee Assistance Program (EAP).

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