Eligibility and Claims Clerk

NY Hotel Trades Council & Hotel Assoc. of NYC Employee Benefit Funds; New York (NY); On-site; USD 50,000 - 68,000; Full time

Job summary

Health Center Inc. (also known as The New York Hotel Trades Council and Hotel Association of NYC, Inc Employee Benefit Funds) is seeking an Eligibility Clerk to perform member services related to claims and eligibility from the Central Administration location in Manhattan.

The role involves analyzing eligibility outcomes and communicating denial, payment levels, or approvals to members and providers, while following established workflows.

Qualifications

• Minimum of 1 year of eligibility, claims, and insurance experience.
• High school diploma or equivalent.
• Excellent interpersonal and customer service skills.
• Ability to work independently and resolve routine inquiries.
• Strong organizational skills and attention to detail.
• Excellent oral and written communication skills.
• Ability to work under pressure and meet deadlines.
• Spanish, Mandarin, or Cantonese speaking a plus.

Responsibilities

• Provide member/customer service in claims and eligibility.
• Analyze and communicate eligibility outcomes, payment levels, and denials to members and providers.

Skills

Interpersonal skills

Customer service

Oral & written comms

Independent work

Organizational skills

Multitasking

Spanish/Mandarin/Cantonese

Education

High school diploma

Job description

Health Center Inc. (also known as The New York Hotel Trades Council and Hotel Association of NYC, Inc Employee Benefit Funds) is a NYC based healthcare organization with ambulatory care facilities staffed with a wide range of health professionals to provide extensive medical and diagnostic services. We have an opening for an Eligibility Clerk based out of our Central Administration location in Manhattan.

Summary:

The primary purpose of this position is to be responsible for providing member/customer service in the areas of claims & eligibility. Following departmental workflows and policies/procedures, employee will analyze and communicate outcomes (eligibility status/payment levels/denials) to members and providers.

Position Qualifications:

Minimum of 1 year of eligibility, claims, and insurance experience

Minimum high school diploma or equivalent.

Excellent interpersonal and customer service skills.

Ability to work independently, handle routine inquiries and resolve issues with minimal supervision.

Excellent organizational skills and attention to detail.

Strong oral and written communication skills.

Ability to work under pressure, meet deadlines and multitask.

Spanish, Mandarin, or Cantonese speaking a plus

We offer a competitive salary ($59,295.44) including, but not limited to, the following benefits:

Medical, Dental, Pharmacy and Vision health benefits at no cost to all benefits-eligible employees and their eligible dependents

Paid Time Off (Vacation, Personal, Sick days, and 12 paid Holidays)

401(k) Plan

Life Insurance

Tuition Reimbursement

Mental Health Coverage

Short Term Disability Benefits

Equal Opportunity Employer