SIHO Insurance Services
Job Title: Eligibility Specialist
Reports To: Manager of Eligibility
This is a non-exempt position with primary responsibility for handling enrollment and eligibility for SIHO customers. This data entry position is also responsible for assisting employer contacts with needs pertaining to eligibility and providing reports and other information as needed.
Brief Description of Duties:
- Respond to telephonic, written inquiries, and emails from accounts concerning eligibility issues.
- Assist internal customers concerning eligibility issues.
- Enroll, terminate, and change eligibility information as requested.
- Initiate and handle student certification, tax dependent verification and disabled dependent verification.
- Maintain eligibility audit reports.
- Process enrollment of new groups as assigned.
- Handle terminations of groups as assigned.
- Track ID Card orders and re-order as needed.
- Track eligibility issues and interactions in the membership system.
- Prepare and communicate special reports as required by accounts.
- Complete special projects (including research) as assigned by the supervisor.
- Develop and maintain statistical data as required.
- Create and mail letters of creditable coverage.
- Serve as backup for Cobra specialist.
- Represent the department when needed for internal and external company meetings.
Minimum Skills Requirement:
- Expert level computer skills (Microsoft Excel and Word)
- Detail oriented – high accuracy rate and attention to detail
- Demonstrated problem solving and analytical skills
- Proven organization and time management skills
- Excellent communications (oral and written) skills
- Excellent customer service skills
- General knowledge and understanding of health insurance
- Ability to work at a self-directed pace in a changing, multi-task environment
- Professional appearance and presence
- Commitment to support and maintain confidentiality in accordance to HIPAA guidelines
- Current PMAS performance evaluation of “3” or higher (for internal candidates)
- Preference given to applicants with Medicare Enrollment and Disenrollment experience
All positions are subject to change based on the needs of the business
Job Type: Full-time
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible schedule
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Education:
- High school or equivalent (Preferred)
Experience:
- Customer service: 1 year (Preferred)
- Patient Access Occupations: 1 year (Preferred)
Work Location: One location
