Eligibility Consultant – Paper Operations

Job Description: • Verify member enrollment status • Make changes to member – demographics, effective and term dates • Addresses a variety of enrollment questions or concerns from the health plan / state • Manual QNXT updates on all fall out edits from the daily, weekly, monthly, quarterly electronic enrollment files • Manually update urgent request received via email from the health plan / state • Work claim inquiries (H03s) • Manually enter temp newborns • Review and manually update all reconciliation reports received from Finance • Responds, researches, and resolves eligibility related issues involving member specific information • Validates benefit plan enrollment information for assigned clients for accuracy and completeness; coordinates the distribution of membership ID cards and partnering with appropriate internal/external support areas involving any requests for ID card customization. • Completes data entry requirements for finalizing new enrollment information as well as for changes and/or terminations. • Partners with other team functions to coordinate the release of eligibility and benefit plan information. Requirements: • Customer Service experience. • Attention to detail and accuracy. • Problem solving skills. • Strong organization skills. • Understands the impact of work to other teams and downstream support areas. • Ability to analyze and research data to make appropriate corrections as necessary. • Strong verbal and written communication skills. • Workplace flexibility - ability to adapt to change. • Knowledge of Health Care and/or MCO’s (preferred). • Knowledge of Enrollment (preferred). • Knowledge Medicaid and/or Medicare (preferred). Benefits: • Affordable medical plan options • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. • Paid time off • Flexible work schedules • Family leave • Dependent care resources • Colleague assistance programs • Tuition assistance • Retiree medical access and many other benefits depending on eligibility.