Billing & Eligibility Specialist- Hybrid- Nashville TN
About The Position
Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest Transparent Communication: be open and clear in all interactions without withholding crucial information Integrity: ensure accuracy in reporting, work outputs and any tasks assigned Truthfulness: provide honest feedback and report any issues or challenges as they arise Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior Ethical Fair Decision Making: ensure all actions and decisions respect company policies and values Accountability: own up to mistakes and take responsibility for rectifying them Respect: treat colleagues, clients and partners with fairness and dignity Confidentiality: safeguard sensitive information and avoid conflicts of interest Hardworking Consistency: meet or exceed deadlines, maintaining high productivity levels Proactiveness: take initiative to tackle challenges without waiting to be asked Willingness: voluntarily offer to assist in additional projects or tasks when needed Adaptability: work efficiently under pressure or in changing environments The Billing/Eligibility Specialist is a key part of the department’s successful operation. The specialist is in daily contact with members, clients, and providers, and therefore needs to be a cheerful, competent and compassionate representative Lucent Health. The position is responsible to assess, interpret and process incoming eligibility feeds through all possible correspondence venues. This includes but is not limited to Cobra requests, Eligibility File Audits, Individual paper eligibility forms and all other potential eligibility inquiries and forms. Attendance can also directly impact the satisfaction level of our clients and retention of our accounts.
Requirements
- 3–5 years of experience in benefits administration within a TPA or health plan environment; experience with self-funded plans with focus on COBRA management.
- Strong understanding of COBRA, HIPAA, ERISA, and ACA regulations.
- Excellent analytical, organizational, and communication skills with strong attention to detail.
- Proficiency in benefit administration systems, data analysis tools, and Microsoft Office applications.
Responsibilities
- Administer and coordinate the day-to-day operations of the COBRA functions to ensure timely and accurate processing of groupand individual COBRA updates.
- Manage COBRA enrollments, terminations, and premium payment updates through our internal systems.
- Respond to COBRA-related inquiries from former employees, beneficiaries, and insurance carriers.
- Stay current with COBRA regulations, ERISA,HIPAAand ACA compliance requirements.
- Coordinate with clients on plans that Lucent does not administer but does administer COBRA for such plans to update outside carriers accordingly with COBRA elections, terms, and changes.
- Generate COBRA reports weekly out of networkingsystem.
- Perform all functions of the B&E role for assigned case load.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
