Eligibility & Enrollment Specialist

A-Line Staffing Solutions; Akron (OH); On-site; USD 57,859,000 - 62,681,000; Full time

Benefits offered by this job

Health insurance

Vision insurance

Dental insurance

Life insurance

Short-term disability

401(k) match

Job summary

A-Line Staffing is seeking an Eligibility & Enrollment Specialist for an on-site role in Akron, OH. The position is full-time (40+ hours/week) with hourly pay of $21.

This role supports healthcare enrollment, eligibility, billing, and claims processes in a contract assignment with potential for permanent hire. Responsibilities include processing enrollment, resolving system errors, investigating third-party transactions, and maintaining compliance with regulations.

Qualifications

• Education: High School Diploma or GED (verifiable).
• Attendance: Commitment to mandatory attendance during the first 90 days.
• 1+ year of healthcare eligibility, enrollment processing, claims operations, or related work.
• Basic proficiency with Microsoft Word, Excel, and Access; 35 WPM accuracy.

Responsibilities

• Process, implement, maintain, and reconcile enrollment and eligibility transactions.
• Review enrollment files and resolve system error reports within timelines.
• Investigate CMS, CMS-related, and third-party vendor transactions for compliance.
• Research legislation affecting enrollment, eligibility, and premium billing.
• Analyze data to identify deficiencies and compliance risks.
• Perform quality-control audits of enrollment and files with vendors.
• Respond to inquiries via portals, email groups, and support lines.
• Conduct outreach to enrollees and employer groups to confirm data.
• Provide professional customer service on eligibility and enrollment status.
• Document inquiries in workflow systems and ensure confidentiality.

Skills

Attention to detail

Strong communication

Analytical thinking

Organizational skills

Independent judgment

Education

High School Diploma or GED

Tools

Word

Excel

Access

Job description

A-Line Staffing is seeking a motivated and detail-oriented Eligibility & Enrollment Specialist This role offers career growth, a supportive work environment, and full-time hours (40+ per week).

ELIGIBILITY & ENROLLMENT SPECIALIST | DETAILS AND COMPENSATION:

Location: Akron OH 44305 – 100% on-site

Payrate: $21/hr

Required Availability: Full-Time | Monday – Friday, 8:00 AM–5:00 PM

ELIGIBILITY & ENROLLMENT SPECIALIST | SUMMARY AND HIGHLIGHTS:

The Eligibility & Enrollment Specialist will support healthcare enrollment, eligibility, billing, and claims-related operations. This position is responsible for accurately processing and reconciling transactions within claims and vendor systems while ensuring full compliance with applicable regulatory and business requirements. This position is a contract assignment with potential to hire on permanently based upon attendance, performance, and business needs

• Benefits are available to full-time employees after 90 days of employment and include health, optical, dental, life, and short-term disability insurance
• A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates

ELIGIBILITY & ENROLLMENT SPECIALIST | RESPONSIBILITIES:

• Process, implement, maintain, and reconcile enrollment and eligibility transactions within claims processing and vendor systems.
• Review enrollment files and resolve system error reports accurately and within established timelines.
• Investigate transactions rejected by CMS, FFM, and other third-party vendors, taking appropriate corrective action under compliance guidelines.
• Research current and proposed legislation affecting enrollment, eligibility, and premium billing functions.
• Analyze data from multiple sources to identify deficiencies, trends, and potential compliance risks.
• Perform quality-control audits of enrollment, reconciliation, and files exchanged with third-party vendors.
• Respond to inquiries received through member/provider portals, assigned email groups, and the Group/Broker support line.
• Conduct outreach to prospective enrollees and employer groups to confirm or clarify submitted enrollment information when needed.
• Provide professional customer service regarding eligibility, billing, enrollment status, coordination of benefits, primary care physician changes, and address updates.
• Document inquiries and complaints in the workflow/document management system and batch correspondence for scanning.
• Maintain strict confidentiality of member health and business information.

ELIGIBILITY & ENROLLMENT SPECIALIST | REQUIREMENTS:

• Education: High School Diploma or GED (verifiable)
• Attendance: Commitment to mandatory attendance during the first 90 days.
• 1+ year of experience in healthcare eligibility, enrollment processing, claims operations, auditing of records/reports, healthcare data processing, or health insurance operations.
• Technical Skills: Basic proficiency with Microsoft Word, Excel, and Access; ability to type at least 35 words per minute with 95% accuracy.
• Core Competencies: Strong attention to detail and excellent proofreading skills.
• Strong analytical and problem-solving abilities with the capacity to exercise independent judgment.
• Professional communication skills suitable for interacting with a wide variety of audiences, including senior leadership.
• Excellent organizational and time-management skills to thrive in a fast-paced environment.

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