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Senior Eligibility Specialist
Chicago, IL
Job Description
SENIOR ELIGIBILITY SPECIALIST
POSITION SUMMARY
This position is responsible for setup and day to day operations of Allied's eligibility services technology platforms. These technology platforms include the following: Allied's eligibility system of record, client web-based eligibility maintenance portal, and X12-834 electronic data interchange (EDI). The eligibility specialist coordinates data transfers, processes data inputs, and troubleshoots data issues while providing frontline support to client contacts and trading partners to answer eligibility and data questions.
ESSENTIAL FUNCTIONS
- Acts as a primary point of contact for clients and vendors
- Communicates eligibility services related updates internally and externally
- Coordinates with Allied's customer service and account management departments to resolve problems
- Coordinates with Allied's eligibility vendor partners to resolve problems
- Configures new group setup in all applicable eligibility services technology platforms i.e. broad understanding of benefit mapping and X12-834 file configuration
- Processes changes, renewals, and open enrollment in all eligibility technology platforms
- Responsible for day-to-day eligibility operations and maintenance
- Reviews eligibility audit reports and processes member updates as required
- Responds to internal and external questions and requests
- Provides training and technical support for clients on Allied's web-based enrollment platform
- Conducts quality assurance testing
- Deploys robust quality protocols and audits to ensure data integrity
- Troubleshoots and escalates issues with Allied's internal and external partners
- Performs additional tasks and duties as assigned
EDUCATION
- Bachelor's degree or equivalent work experience
EXPERIENCE AND SKILLS
- 3-5 years prior benefits administration experience with a strong focus on benefits administration technology and EDI files, required
- Intermediate level work experience with Microsoft Office, Word, Excel, Access and Power Point software applications.
- Communication Skills - excellent written and verbal
POSITION COMPETENCIES
- Job Knowledge
- Time Management
- Accountability
- Communication
- Initiative
- Customer Focus
PHYSICAL DEMANDS
- This is an office environment requiring extended sitting and computer work.
WORK ENVIRONMENT
- Remote
The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.
Job Summary
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
Bachelor's Degree
Required Experience
3 to 5 years
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