Eligibility Specialist

MyTruAdvantage; Columbus, Northern (IN, KY); Hybrid; USD 37,000 - 52,000; Full time

Job summary

MyTruAdvantage in Columbus, IN is seeking an Eligibility Specialist to manage enrollment and eligibility for SIHO customers. This non-exempt role focuses on processing enrollments, terminations, and changes while assisting employer contacts with eligibility needs and generating routine reports.

The ideal candidate has expert Excel and Word skills, experience with database software such as HSP or HealthEx, and strong communication, organization, and confidentiality under HIPAA guidelines.

Qualifications

• Expert level computer skills with Microsoft Excel and Word.
• Ability to work with databases and software applications (e.g., HSP, HealthEx).
• Excellent oral and written communications skills.
• Strong attention to detail and problem-solving abilities.
• Knowledge of health insurance concepts and HIPAA guidelines.

Responsibilities

• Respond to inquiries from accounts concerning eligibility issues.
• Assist internal customers with eligibility concerns.
• Enroll, terminate, and change eligibility information as requested.
• Prepare and communicate special reports for accounts.
• Maintain eligibility audit reports and track ID Card orders.

Skills

Excel

Word

Databases

Tools

HSP

HealthEx

Job description

Job Details

Job Location: 435 Washington Street - Columbus, IN 47201

Job Category: Insurance

Job Title: Eligibility Specialist

Reports To: Manager, Eligibility

This is a non-exempt position with primary responsibility for handling enrollment and eligibility for SIHO customers. This position is also responsible for assisting employer contacts with needs pertaining to eligibility and providing reports and other information as needed.

Brief Description of Duties

• Respond to telephonic, written inquiries, and emails from accounts concerning eligibility issues.
• Assist internal customers concerning eligibility issues.
• Enroll, terminate, and change eligibility information as requested.
• Initiate and handle student certification, tax dependent verification and disabled dependent verification.
• Maintain eligibility audit reports.
• Process enrollment of new groups as assigned.
• Handle terminations of groups as assigned.
• Track ID Card orders and re-order as needed.
• Track eligibility issues and interactions in the membership system.
• Prepare and communicate special reports as required by accounts.
• Complete special projects (including research) as assigned by the supervisor.
• Develop and maintain statistical data as required.
• Create and mail letters of creditable coverage.
• Represent the department when needed for internal and external company meetings.
• Perform other Eligibility Department duties as assigned

Qualifications Minimum Skills Requirement

• Expert level computer skills (Microsoft Excel and Word)
• Ability to work with databases and software applications (e.g., HSP, HealthEx, etc.)
• Highly collaborative with a positive mindset – highly functional in a team-based environment
• Detail oriented - high accuracy rate and attention to detail
• Demonstrated problem solving and analytical skills
• Proven organization and time management skills
• Excellent oral and written communications skills
• Excellent customer service skills
• General knowledge and understanding of health insurance
• Ability to work at a self-directed pace in a changing, multi-task environment
• Professional appearance and presence
• Commitment to support and maintain confidentiality in accordance with HIPAA guidelines
• Current PMAS performance evaluation of “3” or higher (for internal candidates)

All positions are subject to change based on the needs of the business