Eligibility Administrator

Responsibilities

• Examine eligibility transactions received via internal systems, email, electronic files, or client portal for new enrollments, changes, reinstatements, terminations or other assigned work.
• Maintain assigned group workload, ensuring all transactions are processed timely and accurately.
• Approve or process enrollments sent by clients, brokers or trading partners based on department policies, procedures and plan documents.
• Approve or process terminations sent by clients, brokers or trading partners based on department policies, procedures and plan documents.
• Process eligibility changes and reinstatements sent by clients, brokers or trading partners based on department policies, procedures and plan documents.
• Review plan documents, fact sheets and plan recaps to ensure all eligibility transactions meet plan document requirements.
• Utilize approved company storage system to file transaction history and documents.
• Process and manage qualifying events in accordance with requirements within our COBRA partner's system, when necessary.
• Review production metrics provided by leadership on a consistent basis throughout the month.
• Meet assigned goals and metrics surrounding eligibility transactions on a daily, weekly or monthly basis.
• Review incoming quality audits within the required turnaround time.
• Meet assigned quality audit monthly goal.
• Review and reply to eligibility emails in a professional and timely manner.
• Correspond with clients, Client Experience, Member Experiences or other departments and teams to resolve eligibility questions and issues.
• Participate in required training and meetings, one on one coaching sessions, and team huddles.

Requirements

• A High School Diploma or GED.
• 2-4 years of operations experience required or equivalent combination of education and experience.

Skills And Abilities

• High level of accuracy and attention to detail.
• Strong technology skills (Microsoft products).
• Ability to interpret large amounts of data, making sense of transactions.
• Strong verbal and written communication skills with the ability to resonate with others to impact positive outcomes.
• Team player able to collaborate with other departments.

Benefits

• Multiple Health Plan Options.
• Company paid employee premiums for Dental, Vision, STA, & LTD, plus Life Insurance.
• Parental Leave Policy.
• 20 days PTO to start / 10 Paid Holidays.
• Tuition reimbursement.
• 401k Company contribution.
• Professional development initiatives / continuous learning opportunities.
• Opportunities to participate in and support the company's diversity and inclusion initiatives.

Pay

Not specified.

Schedule

100% remote.