Eligibility Coordinator
2 months ago
S&S Health is a premier healthcare administration company located in Cincinnati, Ohio. We offer self, level, and fully funded solutions that lower costs while improving outcomes with a consumer-centric experience. Our integrated benefits, services, and technology platform have been developed to serve the needs of Employers, TPAs, and Health Systems. The company has a nationwide presence with the ability to sell and service in every state.
The Eligibility Coordinator at S&S Health plays a crucial role in ensuring accurate and efficient management of member and group enrollments. This position involves maintaining enrollment databases, responding to eligibility inquiries, and collaborating with internal teams and external vendors to resolve issues promptly.
Responsibilities:
- Load new member or group data into the enrollment database and ensure accuracy of information.
- Update the database with any changes in member or group status.
- Respond to member eligibility inquiries and provide clarification on enrollment status.
- Manage various member correspondence forms and generate membership data reports as needed.
- Reconcile eligibility discrepancies by analyzing transactional data and processing retroactive eligibility changes.
- Take the lead on incoming projects and deadlines related to enrollment processes.
- Collaborate cross-functionally with other departments within S&S Health to ensure seamless operations.
- Interface with external vendors and networks to resolve enrollment and eligibility-related issues.
- Perform additional duties as assigned by management.
Qualifications:
- 2 years of experience in benefits administration and/or insurance-related roles required.
- Working knowledge of eligibility rules and familiarity with HIPAA guidelines.
- Proficiency in basic computer skills including data entry in Excel and basic document handling in Word.
- Excellent verbal and written communication skills to effectively interact with stakeholders.
- Strong organizational skills with the ability to prioritize tasks and manage multiple projects concurrently.
- Ability to work independently and proactively to meet job requirements and deadlines.
- Problem-solving skills with a proactive approach to resolving issues for both internal and external clients.
- Familiarity with COBRA processes and ability to apply COBRA payments in accordance with plan requirements.
- Experience in providing customer service, including handling inbound calls related to enrollment inquiries.
- Proficiency in using Microsoft Office products to generate reports and analyze data.
- High School diploma required; additional post-high school education preferred.
We are committed to creating a safe and secure workplace for all employees. Please note that all final candidates will be subject to a comprehensive background check and drug testing as part of our hiring process.
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