Eligibility & Claims Specialist (Bilingual)

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 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.