Eligibility & Enrollment Processor 2

Zenith American Solutions • Oak Brook, IL

3d

About The Position

The Eligibility & Enrollment Processor 2 supports administration of member eligibility and enrollment activities by maintaining accurate records and responding to member and client inquiries. The role applies knowledge of assigned benefit plans to research and resolve eligibility issues and ensure accurate processing of enrollment information. It contributes to effective customer service and coordinates with internal teams and external vendors to maintain accurate member coverage. The position has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) as defined by the job description and role.

Requirements

• High school diploma or equivalent.
• One year of experience working as an Enrollment & Eligibility Processor.
• Strong work ethic and team-player mentality.
• Integrity and commitment to customer satisfaction.
• Ability to communicate clearly and professionally, verbally and in writing.
• Strong organizational, detail-orientation, and listening skills.
• Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans, and regulations.
• Proficient computer skills, including MS Office tools and applications.
• Ability to work a flexible schedule when workflow requires.
• Must meet established attendance and punctuality guidelines.

Nice To Haves

• Experience working in enrollment administration, benefits administration, or health plan operations.
• Experience working with administrative or enrollment management systems.

Responsibilities

• Maintain current knowledge of assigned benefit plans and apply plan provisions when performing enrollment and eligibility functions.
• Respond to and document telephone, written, and in-person inquiries about plan benefits.
• Maintain member and dependent files in the administration system to ensure enrollment information is accurate.
• Resolve eligibility and enrollment issues with vendors, including PPOs and PBMs.
• Handle inbound and outbound correspondence, including identification cards, eligibility packets, and related enrollment documentation.
• Research and resolve complex and technical issues and irregularities.
• Respond to inquiries from examiners and billing processors related to enrollment issues.
• Perform other duties as assigned.

Benefits

• Health insurance
• Vision insurance
• Dental insurance
• 401(k) with company match
• Paid time off (PTO)
• Opportunities for growth

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED