Benefits Analyst

**100% CONTRACT, ON-SITE***

We are looking for a Benefits Analyst to support union members and their families by delivering accurate benefits administration and responsive service in Pleasanton, California. This Long-term Contract position focuses on medical claims processing, eligibility support, and issue resolution while ensuring compliance with plan rules and regulatory standards. The ideal candidate brings strong analytical skills, bilingual Spanish communication ability, and experience working efficiently in a high-volume benefits environment.

Responsibilities:

• Manage union benefit programs by reviewing and applying plan provisions, policies, and regulatory requirements to daily administrative work.
• Process medical and related benefit claims with accuracy and timeliness while maintaining quality standards in a fast-paced setting.
• Address questions from members, dependents, providers, and other parties through clear and effective written and verbal communication.
• Work with healthcare partners, network organizations, and external vendors to investigate and resolve claim discrepancies or service issues.
• Confirm and maintain member eligibility records across applicable systems and coordinate updates with vendor platforms as needed.
• Support members with benefit concerns, coverage questions, and enrollment or eligibility matters, ensuring clear follow-up and resolution.
• Create reports and maintain complete documentation for claims activity, eligibility records, member contacts, and case outcomes.
• Handle administrative and legal information requests, including subpoena-related responses, in accordance with established procedures and confidentiality standards.
• Stay informed on updates to regulations, medical policies, coding guidance, and claims processing rules that affect benefit operations.
• Protect sensitive personal and medical information by applying sound judgment and strict confidentiality practices in all interactions.
• At least 2 years of experience in medical claims processing combined with customer service responsibilities.
• Fluency in Spanish and English, with the ability to communicate clearly and professionally in both languages.
• Hands-on experience using BeneSys Benefit Driven or a comparable claims administration platform.
• Proficiency with Microsoft Office applications, including Outlook, Excel, and Word.
• Strong interpersonal skills with the ability to collaborate effectively with members, coworkers, and external partners.
• Demonstrated ability to research medical coding updates, policy changes, and claims-related requirements independently.
• Strong organizational, analytical, and multitasking abilities, with close attention to detail and deadlines.
• Ability to work both independently and as part of a team in a high-volume, deadline-driven environment.