What are the responsibilities and job description for the Administrative Services / Eligibility Specialist position at 90 Degree Benefits?
A Turn for the Better. It’s never too late to go a new direction with your health benefits or career. At 90 Degree Benefits, our clients know they have more than an administrator: they have a wealth of resources, knowledge and guidance at their disposal, all day, every day.
We are currently seeking college graduates to start a new and exciting career in our growing healthcare industry in our Katy office. Immediate Full-Time Permanent individuals will be an essential part of our Operations Team working with the Administrative Services team in eligibility.
Ideal candidates will be hard-working professionals, able to undertake a variety of office support tasks, multi-task and work diligently under pressure, with a high degree of attention to detail and discretion all while delivering high quality customer care.
Essential Functions include, but are not limited to:
- Process eligibility enrollments, changes, and terminations accurately and in a timely manner
- Determine and maintain/reconcile member or employee eligibility information in internal systems
- Process and manage inbound EDI 834 enrollment files (adds, terminations, changes)
- Validate and reconcile eligibility data between internal systems and external partners
- Review documentation for completeness and compliance with guidelines
- Investigate and resolve discrepancies in eligibility records and file transmissions
- Monitor EDI file transmissions and ensure timely processing and error resolution
- Work with IT, vendors, and trading partners to troubleshoot file issues and mapping errors
- Maintain accurate records of eligibility transactions and audit trails
Qualifications
- High School diploma/GED required
- 1–3 years of experience in eligibility, benefits administration, HR, or a related field
- Strong attention to detail and accuracy
- Experience with EDI 834 Eligibility Files
- Proficiency in Microsoft Excel and data entry systems (Word/Excel/Outlook) is required
- Excellent organizational and time management skills
- Strong written and verbal communication skills
- Must be able to multi-task, prioritize and maintain quality of work in a fast-paced environment
- Experience exercising critical, independent, judgment and decision making to reach solution-based outcomes
Job Type: Full-time
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Employee discount
- Health insurance
- Life insurance
- Paid time off
- Referral program
- Retirement plan
- Vision insurance
Work Location: In person