Systems and Eligibility Specialist

Relation Insurance Services•San Antonio, TX

About The Position

The Systems and Eligibility Specialist will perform a variety of routine and complex administrative, technical and professional tasks analyzing and administering the various components of the employee benefits programs offered to clients, all while maintaining a very high degree of confidentiality.

Requirements

A Life, Health and Accident License from state of domicile is required within 90 days of hire and must be maintained thereafter.
High school diploma or equivalent required.
Minimum 3 years’ experience in the insurance industry or similar industry.
Prior customer service experience required.
Advanced skills in Microsoft Office (primarily Excel and Word).
Must be computer literate with the ability to learn new software applications, such as online benefit enrollment programs and carrier enrollment sites.
Prior experience multiple benefit eligibility and billing systems.
Demonstrated ability to handle a high level of calls and other communication in a fast-paced environment.
Working knowledge of the laws and regulations associated with HIPAA.
Basic understanding of health insurance plans and enrollment processes including, but not limited to: medical, dental, life, long-term disability (LTD), short-term disability (STD), accidental death and dismemberment (AD&D), vision, etc.
Outstanding interpersonal and communications skills are required to maintain effective relationships with clients, co-workers, carriers, vendors and others.
Ability to work independently with limited daily supervision and to work effectively in a team environment.
Ability to function effectively under tight time constraints, consistently meets strict deadlines, prioritize, and handle multiple tasks in a demanding work environment.

Responsibilities

Maintains systems related to client management, enrollment and eligibility throughout year including employee data, rates, eligibility, plan information and contact information.
Coordinates and prioritizes activity within the eligibility unit to ensure timely completion of client eligibility updates.
Acts as a subject matter expert on eligibility systems.
Updates retirement plan trust accounting system as required.
Answers all correspondence related to clients’ eligibility in a timely manner.
Identifies, researches, and resolves participant benefit issues relative to eligibility and enrollment.
Produces and/or reviews invoices for clients who are using outsourcing and administration services.
Researches and resolves client billing issues to ensure timely payment of monthly premiums.
Assists with managing data within client management system and accounting system including managing the integration between the two systems.
Acts as vendor liaison for commission tracking issues.
Uses accounting and commission tracking system for invoicing and billing clients as necessary.
Reconciles billing and commissions as requested.
Monitors and reviews data completion levels within client management system and provides updates as appropriate.
Works with other Relation business units to install and maintain required eligibility systems.
Trains new employees on the eligibility systems available to clients.
Fully adopts innovative technology, including proprietary AI solutions, into the service process to deliver a best-in-class client service experience.
Performs other projects, duties, and tasks, as assigned.