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9D
90 Degree Benefits
Administrative Services / Eligibility Specialist
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What they do
An Eligibility Specialist provides assistance and information for people who apply for a government benefits program or health care program. Answers questions, assists with an application process, and reviews applications and relevant background information to determine eligibility. May assist eligible applicants with enrolling in a program.
$46,315 / year median in Texas
+19% projected growth
Job Description
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