Stockton, California, United States
Communicates via telephone, in person, online, and written correspondence, answers questions from members, beneficiaries, union local, providers, and other Fund departments regarding the Plans benefits, eligibility, claims processing, and claims appeals. Initiate and review various applications, notices, forms, certifications, self-payments, COBRA, stop payments, clear claim notices through the online platform. Determines eligibility in accordance with Plan rules and resolves eligibility issues and questions. Confirms or denies coverage based on eligibility rules of the members plan.