Health Plan Eligibility Associate

Adventist Health•Roseville, CA

7d•Onsite

About The Position

Coordinates all aspects of health plan eligibility and enrollment for the employee health plan. Performs clerical duties of eligibility management. Works on routine assignments within defined parameters, established guidelines and precedents.

Requirements

High School Education/GED or equivalent: Preferred
Associate’s/Technical Degree or equivalent combination of education/related experience: Preferred
Coordinates all aspects of health plan eligibility and enrollment for the employee health plan.
Performs clerical duties of eligibility management.
Works on routine assignments within defined parameters, established guidelines and precedents.
Processes address changes and return mail for the eligibility team.
Completes member matching for claims that came through unmatched.
Provides information as needed for questions related to medical, dental, vision claims based upon the benefit descriptions, claims payments and processing and plan provisions.
Provides excellent service to members and human resources employees via phone and email inquiries.

Responsibilities

Performs all aspects of health plan eligibility for employees, including, but not limited to: new enrollments, terminations and changes.
Processes address changes and return mail for the eligibility team.
Completes member matching for claims that came through unmatched.
Provides information as needed for questions related to medical, dental, vision claims based upon the benefit descriptions, claims payments and processing and plan provisions.
Provides excellent service to members and human resources employees via phone and email inquiries.
Performs other job-related duties as assigned.