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Benefits Eligibility Specialist

Role overview

Qualifications

  • Bachelor’s degree preferred or equivalent work experience
  • 1-3 years prior benefits administration experience with a strong focus on benefits administration technology
  • Excellent written and verbal communication skills
  • Intermediate skills in Word and Excel; Basic level in Access

Responsibilities

  • Configures new group setup in all applicable eligibility services technology platforms
  • Processes changes, renewals, and open enrollment in all eligibility technology platforms
  • Reviews eligibility audit reports and processes member updates as required
  • Troubleshoots and escalates issues with Allied's internal and external partners

Key facts

Other skills

  • Quality Assurance
  • Microsoft Excel
  • Communication
  • Customer Service
  • Accountability
  • Time Management

About the company

Allied Benefit Systems, LLC logo

Allied Benefit Systems, LLC

Health Insurance (Payers)

Allied is a national healthcare solutions company that works with organizations who choose to take control of their healthcare. We customize employer self-insurance benefits to align with individual choice and organizational need while integrating medical management innovations and cost-control strategies. With healthcare designed for people, employers never have to choose between price and the best-fit insurance products to protect employees and their families. Allied’s philosophy is to create a culture of health for our member organizations and their employees beyond simple, medical health. We integrate administrative services, care solutions and analytics to achieve better clinical, behavioral and social patient outcomes. Allied’s programs and benefit services are designed and structured to infuse value on every front – for employers and HR departments, for plan members and their families, for healthcare providers, and for us. We’re in this together, committed to your future.

Company details

Company typeUnicorn
IndustryHealth Insurance (Payers)
Company size501 - 1000

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Job description

 

POSITION SUMMARY

This Eligibility Specialist is responsible for setup and day to day operations of Allied’s eligibility services technology platforms. These technology platforms include the following: Allied’s eligibility system of record, client web-based eligibility maintenance portal, and X12-834 electronic data interchange (EDI). The eligibility specialist coordinates data transfers, processes data inputs, and troubleshoots data issues.

 

ESSENTIAL FUNCTIONS

  • Configures new group setup in all applicable eligibility services technology platforms
  • Processes changes, renewals, and open enrollment in all eligibility technology platforms
  • Responsible for day-to-day eligibility operations and maintenance
  • Reviews eligibility audit reports and processes member updates as required
  • Responds to internal and external questions and requests
  • Provides training and technical support for clients on Allied’s web-based enrollment platform
  • Conducts quality assurance testing
  • Deploys robust quality protocols and audits to ensure data integrity
  • Troubleshoots and escalates issues with Allied’s internal and external partners 
  • Other duties as assigned

EDUCATION

  • Bachelor’s degree preferred or equivalent work experience

EXPERIENCE AND SKILLS

  • 1-3 years prior benefits administration experience with a strong focus on benefits administration technology
  • Word, Intermediate
  • Excel, Intermediate or better
  • Access, Basic level
  • Communication Skills, excellent written and verbal

POSITION COMPETENCIES

  • Accountability
  • Communication
  • Customer Service Orientation
  • Functional/Technical Skills
  • Quality Focus
  • Time and Task Management

 

PHYSICAL DEMANDS

  • This is a standard desk role requiring extended sitting and computer work

WORK ENVIRONMENT  

  • Remote

 

 

Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Compensation is not limited to base salary.  Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.

Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time.  All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process.  It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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