[Hiring] Eligibility Specialist @One80 Intermediaries

Role Description

The Eligibility Specialist administers the enrollment and/or eligibility functions throughout multi-system infrastructure, imports/exports, eligibility workflows and support to ecommerce sales. Understands the overall architecture of the information systems, QicLink and NewWave, to include external and internal interfaces. Will interact with internal and external constituents in retrieving, importing, exporting and analyzing enrollment data in various formats and presentation types. Various types of analysis, troubleshooting and error-correction will be critical to the success of this position.

• Implements and maintains enrollment/eligibility records for appropriating benefits across various product lines in support of claims and customer service.
• Implements, updates, and maintains automated, user portal, and/or manual eligibility data.
• Interacts with internal partners and/or external clients/vendors.
• Generates reports to identify and resolve discrepancies and watches for headcount variations.
• Documents processes, enhancement requests, user guides, business rules, etc.
• Identifies process improvement opportunities.
• Resolve eligibility discrepancies with clients.
• Ensures data is installed accurately and timely.
• General knowledge of manual and automated eligibility.
• Competent use of all available reporting tools.
• Technical understanding of systems.
• Working knowledge of company infrastructure.

Qualifications

• Comprehensive understanding of related operational support processes.
• Strong planning and organizing.
• Advanced software skills, in MS Word, Excel, Outlook, TextPad/TXT and reporting specifications.
• Use of Secure FTP and encryption.
• Development and management of project work plans through project completion.
• Provide input regarding process improvements on an ongoing basis.
• Work closely with I.T., Client Services, Accounting, Claims, and Executive Management personnel to ensure responsive, timely and effective outcomes.
• Prioritize implementation of assignments to ensure the timely, accurate completion of eligibility processes for new accounts.
• Coordinate the flow of eligibility information from and between various departments.
• Ability to work in a fast-paced, deadline-driven environment.

Benefits

• Health Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance
• Financial Benefits: ESPP; 401k; Student Loan Assistance; Tuition Reimbursement
• Mental Health & Wellness: Free Mental Health & Enhanced Advocacy Services
• Beyond Benefits: Paid Time Off, Holidays, Preferred Partner Discounts and more.

Pay Range

$20.00 - $20.00 Hourly

The pay range provided above is made in good faith and based on our lowest and highest annual salary or hourly rate paid for the role and takes into account years of experience required, geography, and/or budget for the role.