Enrollment & Eligibility Services Assistant I - (In Office)

Responsibilities

• Process standard enrollment applications and eligibility updates for active, COBRA, retiree, and disability coverage in accordance with plan rules
• Review, verify, and validate dependent documentation (e.g., birth certificates, marriage licenses, guardianship forms) and update records under guidance
• Handle routine qualifying life events (QLEs), COBRA enrollments, and generate standard self-pay notices
• Support retiree transitions, including Medicare coordination and self-pay enrollment intake
• Perform routine updates to carrier and vendor portals for enrollments, terminations, and demographic changes
• Apply employer-submitted hours and demographic data to maintain accurate eligibility records
• Assist with nightly batch processing of rosters, terminations, and reinstatements
• Conduct outreach to members and employers to collect missing or incomplete documentation, including for dependent verification
• Follow up with employers regarding late or missing hours files and contribution payments as part of the delinquency tracking process
• Respond to standard inquiries from members, HR departments, and employers regarding eligibility status, documentation, and plan rules
• Assist with open enrollment processing, including intake, verification tracking, and updates
• Support employer onboarding efforts by assisting with portal use and file submission protocols under supervision
• Maintain compliance with HIPAA and internal privacy standards in all communications and record handling
• Assist with audit preparation, eligibility reporting, and data cleanup projects as directed
• Escalate complex or unclear eligibility issues or employer data discrepancies to the Team Lead or Management