Eligibility Specialist I @LE701 Avesis, LLC

[Hiring] Eligibility Specialist I @LE701 Avesis, LLC

Apr 04, 2025 - LE701 Avesis, LLC is hiring a remote Eligibility Specialist I. 💸 Salary: $15.20 - $23.73 per hour. 📍Location: USA.

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Role Description

This position will report directly to the Supervisor of New Business Services and will work alongside several team members, including the Team Lead. The Eligibility Specialist I will be responsible for learning all relevant internal systems, along with industry eligibility requirements and expected turnaround times to process new enrollments, handle change requests, and terminate current enrollments.

Support vision and dental clients, along with brokers and general agents with daily administrative duties, including new member adds, terminations, and demographic changes.
Apply common processing rules within business, like overage dependent limits, student verification process, IRS Disability rules, SB51 (Texas) and other rules as needed.
Determine the differences between Employer Paid groups versus Voluntary groups and apply the correct processing rules.
Recognize the acceptable and approved applications for processing enrollments to meet underwriting guidelines.
Identify the different Qualifying Events for member terminations and additions, which are requested outside of Open Enrollment period and take the appropriate action.
Proficient in Outlook to support and organize a shared inbox with multiple team members.
Triage and assign emails to appropriate stakeholders, develop comfortability with high email volumes entailing a wide range of requests, identify missing details, and initiate the necessary outreach to complete requests.
Maintain a minimum of 60% accuracy focused on quality within each enrollment request.
Complete at least 5 emails per day, while building confidence to effectively triage emails and meet department turnaround time of 5 business days.
Collaborate with internal departments including Account Management, Sales, and Implementation, to resolve enrollment related issues, increase levels of engagement, and discuss new process opportunities.
Other duties as assigned that will impact client satisfaction, improve department performance, and drive a quality brand.

Qualifications

College degree preferred, high school diploma or equivalent required.
Basic knowledge in Microsoft applications, 2 years of experience in Excel and Word, including creating, filtering, and formatting spreadsheets and templates.
1-2 years of experience in the health plan industry, including working with highly confidential information.
Experience in the health plan eligibility sector.
Must have attention to detail and multi-tasking skills.
Experience working in a fast-paced environment to meet strict deadlines.
Strong keyboard skills, averaging 60 WPM.

Requirements

As this role is a remote role, you are required to maintain internet service that allows you to complete your essential job duties without issue. Rates of 50 Mbps download and 10 Mbps upload while hardwired and not on a VPN are sufficient.

Benefits

Meaningful and challenging work opportunities to accelerate innovation in a secure and compliant way.
Competitive compensation package.
Excellent medical, dental, supplemental health, life and vision coverage for you and your dependents with no wait period.
Life and disability insurance.
A great 401(k) with company match.
Tuition assistance, paid parental leave and backup family care.
Dynamic, modern work environments that promote collaboration and creativity to develop and empower talent.
Flexible time off, dress code, and work location policies to balance your work and life in the ways that suit you best.
Employee Resource Groups that advocate for inclusion and diversity in all that we do.
Social responsibility in all aspects of our work. We volunteer within our local communities, create educational alliances with colleges, drive a variety of initiatives in sustainability.

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📍	Be aware of the location restriction for this remote position: USA
‼	Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more.

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Eligibility Specialist I @LE701 Avesis, LLC

Customer Service

Salary 💸 $15.20 - $23.73 per hour	Remote Location USA
Job Type full-time	Posted Apr 04, 2025

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📍	Be aware of the location restriction for this remote position: USA
‼	Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more.

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[Hiring] Eligibility Specialist I @LE701 Avesis, LLC

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