Eligibility Specialist I

TEXAS ASSOCIATION OF COUNTY OFFICIALS•Austin, TX

14d•$29 - $31•Onsite

About The Position

The Eligibility Specialist is responsible for data entry, analysis and accuracy of eligibility information for the Texas Association of Counties Health and Employee Benefits Pool (Pool), including eligibility determinations. Coordinates with the Pool’s vendors to address eligibility issues. Responsible for new member applications and the Pool’s annual coverage renewal process.

Requirements

High school diploma or equivalent required.
A minimum of two years’ work experience in health coverage eligibility, business administration, health administration, accounting, or related field required.
Position requires excellent communication skills, both written and verbal, and the ability to relate to individuals with a variety of cultural, economic and educational backgrounds.
Position requires a high degree of professionalism in representing TAC in contacts with members.
Must be proficient in use of personal computer and Microsoft Office products including: Word, Excel, and PowerPoint.
Experience with data entry and use of mail merge function required.
Must function independently with minimal supervision.
Accurate and rapid data entry skills required.
Data analysis and interpretation skills required.
Excellent time management and record keeping required

Nice To Haves

Bachelor’s degree in business administration, health administration, accounting, or related field preferred.
Knowledge of employee benefit programs and procedures preferred.

Responsibilities

Maintains accurate and timely eligibility data within the Pool’s eligibility system, including data entry, verification, analysis, reconciliation, and quality control.
Responsible for maintaining and updating contact and system user information.
Develops and maintains expertise in the administration and maintenance of the Pool’s eligibility system.
Maintains working knowledge of Pool coverages, eligibility systems, applicable contracts, and relevant federal laws (including COBRA, PPACA, HIPAA, and Medicare).
Monitors eligibility discrepancies and coordinates with Pool vendors and internal staff to research, resolve, and document issues in a timely manner.
Responsible for accurate self-bill reporting, billing preparation, and related reconciliations for the Pool’s vendors.
Responds to inquiries from Pool members and participating entities regarding eligibility, membership, benefits, COBRA participation, and billing procedures.
Assists with annual renewal processing including gathering group renewal information, system setup, data processing, testing, validation, and troubleshooting.
Administers new member application process and participates in the annual membership renewal cycle.
Assists with new group implementation.
Participates in planning, development, implementation, and evaluation of special projects, including new program initiatives and system enhancements.
Performs other duties as assigned.