Case Studies

3RD PARTY BENEFITS ADMIN

• Resolve Process Deficiencies

Issue
Covered third party employee accounts had not been reconciled nor transacted properly since company inception. This brought out other items that required attention: Was the Employer billed the proper amount? Was the insurance carrier over charging? Did the new enrollees get submitted and covered by the insurance carrier? Has the covered employee been over or under contributing towards their coverage? What was the cash impact on the client? There were no processes in place to ensure proper billings, reconciliations, and accurate employee benefit balances. 

Solution 
› Reconcile the member accounts, plan payments and contributions to the insurer billings. 
› Design business process changes to enure proper member account maintenance and accurate insurance payments. 
› Wrote company training manual, including member account reconcilation procedures. 

Benefits 
› Reconciled member benefits accounts supported improved cash flow projections and insurer billing accuracy. 
› Training manuals availble for staff training and new employee onboarding. 

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