Enrollment & Eligibility Services Assistant I (Hybrid)
About The Position
This is a hybrid role supporting the Culinary Health Fund, with a combination of in-office presence and remote work based on business needs. In this position, you will focus on eligibility, enrollment, and premium-related functions, serving as a key resource for members and internal partners through various communication channels rather than daily in-person interactions. You will collaborate closely with cross-functional teams—including Customer Service, IT, and Accounts Payable—to resolve issues, ensure data accuracy, and support efficient, high-quality service delivery. This is a bargaining unit position represented by POPA.
Requirements
- Ability to work alternate schedules/hours based on the business’s need.
- 2+ years of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties
- Knowledge of managed care, labor and commercial carrier enrollment and eligibility procedures including hourly based eligibility and waiting periods.
- Moderate proficiency with Windows PC applications, which includes the ability to learn new and complex computer system applications
- Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product
- Ability to work independently
Nice To Haves
- Prior experience with premium billing and reconciliation, knowledge of 834 eligibility files and transaction sets a plus.
- Fluent in COBRA, FMLA, QLE’s and other eligibility related transactions a plus
Responsibilities
- Handles in-person member transactions by collecting cash and credit card payments, accurately processing payments, issuing receipts, and providing correct change while maintaining strict adherence to financial controls and confidentiality requirements.
- Verify the loading new member or group data into the enrollment database & update the database with changes
- Responding to member eligibility or group questions & verify enrollment status
- Reconciling eligibility discrepancies, analyzing transactional data & submitting retroactive eligibility changes
- Inventory control of member and group transactions
- Support the Eligibility Call Center Representatives
- Ability to work with various types of member communication
- Working with our IT department to investigate and validate member eligibility
- Works directly with the Accounts Payable team to review and resolve any premium issues including outreach to members, clients and State officials as needed
- Communicate effectively with individuals/teams in the program to ensure high quality and timely expedition of customer requests
- Participate in activities designed to improve customer satisfaction and business performance.
- Use decision-support tools to answer questions, where needed.
- Solve problems that are sometimes unstructured and that may require reliance on conceptual thinking. Work is frequently completed without established procedures
- Maintain broad knowledge of client requirements, procedures and key contacts.
- Support projects and other departments in completing tasks/projects
- Other duties as required
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
