Participant service representative vs benefits representative

Differences between participant service representative and benefits representative duties and responsibilities

Participant service representative example responsibilities.

• Educate veterans and the college community on veteran's benefits and academic requirements need to accomplish academic goals.
• Educate employees in the FMLA process.
• Answer questions in regards to FMLA and payroll.
• Act as primary liaison between AVP and assign key clientele.
• Supervise multiple medical orders for largest AVP corporate account on a daily basis via telephone, fax and email.
• Submit insurance claims; review and problem-solve return, dispute, or reject claims from Medicare and other third-party payers.
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Benefits representative example responsibilities.

• Determine eligibility and process FMLA initial notification letters for employees which lead to immediate use of benefits.
• Service consumers inbound inquires via phone and live chat regarding HRA, FSA and HSA accounts.
• Work with clients to ensure ACA compliance.
• Train in and apply HIPAA privacy and security regulations and maintain strict confidentiality of claims.
• Contact any FSA or HRA groups concerning any outstanding payments for claims and/or admin fee invoices.
• Produce benefit-related reports from HRIS.
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