Eligibility Specialist

This is a fully remote position, open to applicants in Florida.

📋 Description

• Oversee enrollment and eligibility tasks across a multi-system infrastructure.

• Handle imports, exports, eligibility workflows, and support for ecommerce sales.

• Collaborate with QicLink, NewWave, and both external and internal interfaces.

• Retrieve, import, export, and analyze enrollment data in various formats.

• Conduct analysis, troubleshoot issues, and correct errors.

• Implement and sustain enrollment and eligibility records that support benefits, claims, and customer service.

• Update and maintain automated, user portal, and manual eligibility data.

• Engage with internal partners and external clients/vendors.

• Generate reports to identify and address discrepancies and monitor headcount changes.

• Document processes, enhancement requests, user guides, and business rules.

• Identify opportunities for process improvement.

• Resolve eligibility discrepancies with clients.

• Ensure accurate and timely data installation.

• Coordinate the flow of eligibility information across departments.

• Collaborate with I.T., Client Services, Accounting, Claims, and Executive Management.

⛳️ Requirements

• Thorough understanding of relevant operational support processes.

• Strong skills in planning and organization.

• Advanced proficiency in MS Word, Excel, Outlook, TextPad/TXT, and reporting specifications.

• Experience with Secure FTP and encryption methods.

• Capable of developing and managing project work plans until completion.

• Ability to provide ongoing input on process improvements.

• Capacity to work closely with I.T., Client Services, Accounting, Claims, and Executive Management teams.

• Ability to prioritize tasks for the timely and accurate completion of eligibility processes for new accounts.

• Skill in coordinating the flow of eligibility information between departments.

• Ability to thrive in a fast-paced, deadline-driven environment.

• General knowledge of both manual and automated eligibility processes.

• Proficient in using reporting tools.

• Technical understanding of systems.

• Familiarity with company infrastructure.

🏝️ Benefits

• Medical/Rx

• Dental

• Vision

• Life Insurance

• Disability Insurance

• ESPP

• 401k

• Student Loan Assistance

• Tuition Reimbursement

• Free Mental Health & Enhanced Advocacy Services

• Paid Time Off

• Holidays

• Preferred Partner Discounts