Eligibility Coordinator

2 weeks ago


Cincinnati, United States S&S Healthcare Full time
Job DescriptionJob Description

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 Insurance Eligibility Coordinator prepares processes and maintains new member or group enrollments.

Essential Functions:

  • Load new member or group data into the enrollment database & update the database with changes.
  • Respond to member eligibility or group questions & verify enrollment status.
  • Work with various types of member correspondence forms and membership data reports.
  • Be responsible for reconciling eligibility discrepancies, analyzing transactional data & submitting retroactive eligibility changes.
  • Take the Lead on incoming projects and deadlines.
  • Work with outside vendors and networks to resolve enrollment/eligibility inquiries.
  • All other duties as assigned.
  • Ability to work cross-functionally with other S&S Health departments.

Minimum Qualifications:

  • 2 year of experience in benefits and/or insurance required.
  • Working knowledge of eligibility rules and HIPAA guidelines.
  • 1 year of basic computer skills required, Excel- entering data Word- basic.
  • Ability to communicate clearly and effectively both verbally and in writing.
  • Ability to organize work and priorities.
  • Must be able to work multiple projects concurrently.
  • Capable of working independently to meet job requirements.
  • Able to research and resolve problems to meet both internal and external client needs.
  • Ability to utilize and understand the COBRA process along with the system functionalities to follow the process.
  • An understanding of COBRA.
  • Provide Customer Service by answering inbound calls.
  • Demonstrated ability to use Microsoft Office products.
  • Regular and reliable attendance is a requirement of the position.

EDUCATION

  • High School diploma with some post high school education is preferred.






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