The Member Services Representative (MSR) II serves as an experienced resource within the Member Services Department, providing advanced support to members, retirees, beneficiaries, dependents, employers, and vendors regarding Fund benefits, including Health & Welfare, Pension, Annuity, Vacation, Scholarship, and related programs. MSR II handles complex inquiries, resolves escalated issues, conducts benefit research, and serves as a liaison between members, internal departments, and external vendors.
This role requires strong benefit knowledge, sound judgment, and effective communication in a fast-paced, high-volume environment. The ideal candidate is customer-focused, detail-oriented, and able to interpret benefit plan provisions while maintaining confidentiality and delivering a positive member experience.
ESSENTIAL DUTIES
- AND RESPONSIBILITIES Member Services & Benefit Administration Serve as a primary resource for resolving complex member inquiries regarding eligibility, Pension, Annuity, Vacation, Scholarship, and Health & Welfare benefits.
- Research and investigate member account issues and benefit discrepancies, utilizing multiple systems and available documentation.
- Review and analyze member records to ensure accuracy, completeness, and compliance with Fund policies and procedures.
- Assist members in understanding benefit provisions, eligibility requirements, enrollment processes, and applicable deadlines.
- Provide accurate and timely information regarding Fund programs while maintaining exceptional customer service standards.
- Conduct member verification processes in accordance with established procedures and security protocols.
- Prepare and provide requested member documentation Assist members with account maintenance activities, including updates to personal information, beneficiary designations, and documentation requirements.
- Issue Resolution & Escalation Management Resolve escalated member concerns through effective problem-solving, research, and collaboration with internal departments.
- Investigate and reconcile pension credit discrepancies and other complex benefit-related issues.
- Facilitate conflict resolution by professionally addressing member concerns and identifying appropriate solutions.
- Escalate sensitive or high-risk issues to management while providing detailed documentation and recommendations.
- Ensure all member interactions are handled professionally, empathetically, and in accordance with organizational standards.
- Vendor & Department Liaison Functions Serve as a liaison between members and third-party vendors, including insurance carriers, pension administrators, audit vendors, and other service providers.
- Coordinate with internal departments including Pension, Welfare, Eligibility, Accounting, and Information Technology to resolve member concerns.
- Assist members in navigating vendor requirements and obtaining necessary documentation.
- Operational Support Review incoming forms and supporting documentation for completeness, accuracy, and compliance with Fund requirements.
- Obtain additional information from members, providers, employers, or vendors when necessary to facilitate processing.
- Process Rapid!
- Pay Card requests in accordance with validation procedures and established controls.
- Assist with Social Security merge processes and related member account maintenance activities.
- Accurately document all member interactions, inquiries, complaints, resolutions, and follow-up actions within applicable systems.
- Maintain confidentiality of sensitive information and comply with HIPAA regulations and organizational privacy standards.
- Leadership, Training & Development Serve as a mentor and resource to Tier I Member Services Representatives.
- Reinforce departmental procedures, customer service standards, and best practices.
- Participate in departmental meetings, training sessions, and continuous improvement initiatives.
- Support management with special projects, operational initiatives, audits, and other business priorities.
- Compliance Maintain a thorough understanding of Fund rules, benefit plans, organizational policies, and applicable regulations.
- Utilize plan documents, Summary Plan Descriptions (SPDs), user guides, and Standard Operating Procedures (SOPs) when assisting members.
- Adhere to all departmental procedures and quality standards.
- Exercise independent judgment while ensuring compliance with organizational policies and regulatory requirements.
