E.D.I.S. has a management team with a combined total of more than 350 years in the industry, a sales team with a combined total of more than 45 years of experience, and a staff that stands behind the service we provide.
We are committed to walking out of the office each day knowing that we've put forth the best effort to produce the highest quality result possible for each of our clients.
E.D.I.S. maintains all the proper licensing required of a TPA in multiple states in which it does business. Additionally, E.D.I.S. holds multiple bonds and policies as required by ERISA for each client's protection. Each state in which we are licensed requires annual recertifications whereby all audits, licensing, bonds and policies are updated.
We want to be the TPA whose actions make it clear that we are here to serve you, our partner and our clients. We would be honored if you would trust us with your business.
Chief Barketing Officer
Director of Bellyrubs
Director of Trash Relocation
Paw-blic Relations Director
Join Our Team
Employer Driven Insurance Services is all about hiring quality people. We truly believe quality people doing quality work is what allows us to provide a quality result for our clients. We are focused on finding team members who will be with us for the long run, who are going to grow in their talents and advance into positions that truly utilize their strengths. We believe that being part of a successful work family is just one element of a truly happy and balanced life. Because of that belief, we offer medical, dental, vision, matching 401K and paid vacation, holidays and sick time to our full-time employees. To find out if E.D.I.S is the right place for you, submit your resume to email@example.com. We look forward to hearing from you regarding the open positions below:
Summary: Manages incoming calls from members, providers, brokers, and agents. Researches issues to find resolution for the caller and manages response time to achieve 24 hour turnaround. Accesses claim system to respond to caller and to adequately track calls received. Works with other members of the Customer Service team to achieve team goals in the areas of speed of answer and calls per day. Assists with customer inquiries as needed for other areas of the office and acts as a resource in the resolution of difficult issues. Duties and Responsibilities: • Receive, investigate and respond to all customer inquiries when taking incoming calls • Manage incoming calls and resolve issues within 24 hour turnaround. • Manages follow up system so all unresolved calls receive a call back and resolution within required timeframes. • Monitor e-mails and respond to all questions and inquiries within established timeframes. • Adhere to work schedules (lunch and breaks) to achieve maximum service capacity • Assist with refund recovery process and complete research as needed. • Track all calls taken using acceptable call tracking vocabulary and processes. • Handles all open calls within established timeframes. • Complete outgoing customer calls to explain benefits and claim status. • Completes outreach calls to assigned groups to insure service levels are maintained. • Work with Claim department to identify error trends and ensure claim adjustments are communicated properly. Qualifications: • Must have a high school diploma or GED • Two years customer service experience • Insurance industry experience required • Bilingual in Spanish a plus
Job Summary: Manages Concierge service, monitoring all processes and metrics to ensure optimal turnaround and service to customers. Researches issues to find resolution for the user and manages response time to achieve established turnaround metrics. Takes incoming calls and makes outreach calls to determine cause of issues with concierge service. Educates members on the concierge process and how to use the system. Provides feedback to manager regarding issues and problems that are detected and works with IT and other areas to ensure process is meeting expectations. Duties and Responsibilities: Receive, investigate, and respond to all concierge issues. • Manage incoming questions regarding the concierge process and serves as a resource to Benefit Advisors regarding the concierge service. • Monitors the concierge claim pulls and communicates with Claim staff to ensure all claims are pulling properly. • Tracks daily output to ensure all claims are pulling as needed. • Manages follow up and resolution to concierge issues and documents issues for manager. • Monitors e-mail and respond to all questions and inquiries within established timeframes. • Makes outreach calls to members who are experiencing issues with concierge system and educates as needed. • Adhere to work schedules (lunch and breaks) to achieve maximum service capacity • Work with Claim department to identify error trends and ensure customer issues are resolved and communicated properly. Qualifications: • Must have a high school diploma or GED. • Minimum of two years customer service experience. • Insurance industry experience preferred.
Job Summary: Receives and processes new business across all product lines. Provides effective communication verbally and in writing to the writing agent, the group and the appropriate sales team member. Additionally, handles all aspects of the renewal process for designated business. Essential Functions: • Breaks down and ensures accuracy and completeness of new and renewing business. • Keeps the agent, group and sales member in the loop through professional communication both verbal and in writing. • Interacts with carriers, general agents, plan loading, accounting and administration to ensure all information for new case start up is delivered. • Notifies inside sales representatives and manager of any serious service issues which may impact group’s implementation or retention. • Ensures the benefits are correct as received. • Researches carrier benefits and makes recommendations for integration of our product with new benefit plans for renewing groups. • Completes documentation in CSI and any other necessary documentation in the required timeframe. • Delivers financial reports to sales team, clients and supports brokers with renewal activity. • Attends weekly/monthly sales meetings when needed and interacts with other members of the Sales/ Field Service Team to establish best practices and improve service levels. Competency Requirements: • Excellent organizational skills • Time management skills with focus on prioritizing tasks • Leadership skills and experience working independently • Problem solving and decision making ability. • Proven interpersonal skills, experienced in customer relations. • Ability to influence outside partners and identify positive alternatives to claim system limitations. • Computer knowledge with skill to navigate Web. Work Experience & Education Requirements: • The position requires three or more years experience in the insurance industry with focus on benefit plans and agent/client communication.
PLAN DOCUMENT COORDINATOR
Job Summary: Creates, reviews and edits plan documents associated with client benefit plans. Manages checklists and/or forms required for the collection of data needed to complete benefit plan documents for compliance services groups. Completes the movement of plan documents to appropriate folders and systems for file and publication. Assists Administration Dept. with data projects. Essential Functions: • Create, review and edit ERISA compliant documents related to benefit plans • Ensures plan documents are exported to the appropriate web portal • Verifies all information is provided to process new or renewing Compliance Services groups and contacts employer if additional information is needed. • Interprets updated required language for inclusion in plan documents and prepares amendments if necessary • Performs quality checks as needed Competency Requirements: • Excellent organizational skills • Time management skills with focus on prioritizing tasks • Ability to work both independently and in a team setting • Ability to read, analyze and interpret information as it pertains to compliance-related functions and regulations • Problem solving and decision making experience. • Detail orientation with experience in data input. • Excellent communication skills both written and verbal • Proven interpersonal skills and ability to interact with other areas to satisfy customer needs • Computer knowledge with skill to navigate Web and locate information Required Skill / Experience: • Insurance knowledge with a preferred minimum of 2 years working in insurance industry • Knowledge of group health benefits and carrier plans
Why E.D.I.S is Set Apart From the Rest
· In its first year, E.D.I.S. wrote more than 100 stop loss clients becoming the top TPA in the nation for its stop loss carrier.
· E.D.I.S. ensures that every stop loss, MEC plan it offers includes complete aggregate protection to reduce and limit an employer’s plan liability.
· E.D.I.S. was the first TPA in California to implement solutions to overcome the strict self-funding regulations of SB-161 which requires alternative set up and additional tracking.
· Our EDHP™ program returned more than 2 million in unused claims funds to its clients in 2017 and is on target to surpass that in 2018. Where other stop loss carriers and TPA’s keep a portion of the unused claims fund, E.D.I.S. returns 100% to the employer.
· E.D.I.S. is also committed to returning 100% of any pharmacy rebates received through its EDHP™ program to the client whose member has earned it. This is another area where other TPA’s keep the money, or only pass a small percentage through to its client.
· For no additional charge, E.D.I.S. provides a mobile friendly Online Web Portal, Concierge Service, creation and maintenance of required ERISA documents to include a Summary Plan Description, Plan Document, Summary of Benefits & Coverage, Notice of Material Modification and ACA required notices.