Eligibility and Enrollment Specialist

A-Line Staffing is seeking a motivated and detail-oriented Eligibility & Enrollment Specialist This role offers career growth, a supportive work environment, and full-time hours (40 per week).

If interested in this Eligibility & Enrollment Specialist position APPLY NOW for IMMEDIATE consideration

ELIGIBILITY & ENROLLMENT SPECIALIST | DETAILS AND COMPENSATION:

• Location:  Akron OH 44305 – 100% on-site
• Payrate: $21/hr
• Required Availability: Full-Time | Monday – Friday, 8:00 AM–5:00 PM

ELIGIBILITY & ENROLLMENT SPECIALIST | SUMMARY AND HIGHLIGHTS:

The Eligibility & Enrollment Specialist will support healthcare enrollment, eligibility, billing, and claims-related operations. This position is responsible for accurately processing and reconciling transactions within claims and vendor systems while ensuring full compliance with applicable regulatory and business requirements.

• This position is a contract assignment with potential to hire on permanently based upon attendance, performance, and business needs
• Benefits are available to full-time employees after 90 days of employment and include health, optical, dental, life, and short-term disability insurance
• A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates

ELIGIBILITY & ENROLLMENT SPECIALIST | RESPONSIBILITIES:

• Process, implement, maintain, and reconcile enrollment and eligibility transactions within claims processing and vendor systems.
• Review enrollment files and resolve system error reports accurately and within established timelines.
• Investigate transactions rejected by CMS, FFM, and other third-party vendors, taking appropriate corrective action under compliance guidelines.
• Research current and proposed legislation affecting enrollment, eligibility, and premium billing functions.
• Analyze data from multiple sources to identify deficiencies, trends, and potential compliance risks.
• Perform quality-control audits of enrollment, reconciliation, and files exchanged with third-party vendors.
• Respond to inquiries received through member/provider portals, assigned email groups, and the Group/Broker support line.
• Conduct outreach to prospective enrollees and employer groups to confirm or clarify submitted enrollment information when needed.
• Provide professional customer service regarding eligibility, billing, enrollment status, coordination of benefits, primary care physician changes, and address updates.
• Document inquiries and complaints in the workflow/document management system and batch correspondence for scanning.
• Maintain strict confidentiality of member health and business information.

ELIGIBILITY & ENROLLMENT SPECIALIST | REQUIREMENTS:

• Education: High School Diploma or GED (verifiable)
• Attendance: Commitment to mandatory attendance during the first 90 days.
• 1 year of experience in healthcare eligibility, enrollment processing, claims operations, auditing of records/reports, healthcare data processing, or health insurance operations.
• Technical Skills: Basic proficiency with Microsoft Word, Excel, and Access; ability to type at least 35 words per minute with 95% accuracy.

Core Competencies:

• Strong attention to detail and excellent proofreading skills.
• Strong analytical and problem-solving abilities with the capacity to exercise independent judgment.
• Professional communication skills suitable for interacting with a wide variety of audiences, including senior leadership.
• Excellent organizational and time-management skills to thrive in a fast-paced environment.

Take the Next Step!

Join a company that values your growth and contributions. If you’re interested in the Eligibility & Enrollment Specialist role apply now or contact us for immediate consideration!

Brittney Blackman