Job Description
Job Description
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