Enrollment & Eligibility Specialist II

3 weeks ago


New York, United States Building Service 32BJ Benefit Funds Full time
Job DescriptionJob DescriptionJob Title: Eligibility & Enrollment Specialist II

Labor Grade: 8

Department: Eligibility

FLSA Status: Non-Exempt (Local 153)

Salary Range: As established by contract

Summary:

The Eligibility and Enrollment Specialist serves as a member of a cross-functional team responsible for participant and dependant enrollment and eligibility. The Eligibility and Enrollment Specialist is primarily responsible for reviewing and updating enrollment and eligibility data and for making changes to participant and dependents records in the Funds’ benefit administration system(s) to ensure compliance with the Fund rules. The Eligibility and Enrollment Specialist reports to the Supervisor of Eligibility Processing Group (EPG).

Essential Duties and Responsibilities:

  • Maintain member and dependent's eligibility and enrollment records according to the terms of appropriate Collective Bargaining Agreement and 32BJ rule
  • Maintain member roster records, where needed.
  • Use all means to explain member and dependent eligibility and work history and other available resources as necessary.
  • Record and escalate any system related defect in a timely manner.
  • Collect and analyze data/information to resolve a problem in real time.
  • Understand EPG processes and procedures and recommend solutions for improvement.
  • Update eligibility information in vendor systems as required.
  • Review vendor eligibility error reports and report on resolutions.
  • Issue letters from to participants regarding various situations, including drafting of one-off letters.
  • Complete all enrollment and eligibility related transactions in a timely and accurate manner as per department guidelines, including escalations.
  • Escalate all unusual cases and/or problems to the EPG Supervisor for review and resolution.
  • Intake and review of member's eligibility related requests for research and resolution, with their submission to the other 32BJ departments, if necessary.
  • Understand and be able to identify special eligibility contracts and their effects on eligibility rules.
  • Review data for accuracy and compliance with Fund rules and guidelines.
  • Perform any other relevant, related or pertinent work or duties as requested or assigned.

Technical Skills:

  • Detailed knowledge of benefits and processing system(s)
  • Demonstrated capability to manipulate and use multiple software programs simultaneously including Excel, Microsoft Word, and Windows applications.
  • Strong analytical, problem solving and trouble shooting skills.
  • Excellent organizational and prioritizing skills.
  • Flexibility with work schedule.

Interpersonal Skills:

  • Strong oral and written interpersonal skills.
  • Demonstrated customer service orientation.
  • Ability to effectively operate in fast-paced work environment and meet deadlines
  • Excellent listening skills.
  • Detail oriented with excellent organization skills and communication skills

Education and /or Experience: High School diploma, GED or equivalent experience, Call Center/Walk-In Center experience or Health Care Customer Service background is a plus.
Language Skills: Read, write and understand English. Additional language abilities a plus.
Reasoning Ability: Above average.
Certificates, Licenses, Registrations: None



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