Eligibility Specialist

AppleOne; Pleasanton (CA); On-site; USD 44,000 - 50,000; Full time

Job summary

AppleOne Employment Services is seeking an Eligibility Specialist for a temp-to-hire opportunity in Pleasanton, CA. The role supports enrollment processing, customer service calls, and administrative follow-up in a benefits-focused setting.

Ideal candidates have 5+ years of customer service experience in medical/healthcare/insurance, strong Excel/Word/Outlook skills, and exceptional communication. A high school diploma is required, with Associate degree preferred.

Qualifications

• Minimum high school diploma required.
• 5+ years of customer service experience, preferably in medical/benefits/healthcare.
• Proficiency in Word, Outlook, Excel at an intermediate level; able to complete skill evaluations.

Responsibilities

• Answer incoming customer service calls and assist members, providers, and related contacts.
• Follow up on eligibility, enrollment, and application inquiries promptly.
• Prepare enrollment packets and ensure documents are complete and accurate for mailing or processing.
• Process applications and eligibility materials per procedures and deadlines.
• Maintain organized records and track pending items to support workflow.
• Assist with general administrative duties and special projects as needed.

Skills

Customer service

Communication

Problem solving

Detail oriented

Time management

Team player

Reliability

Under pressure

MS Office proficient

Education

High school diploma

Associate degree or higher

Tools

Microsoft Word

Microsoft Outlook

Microsoft Excel

Job description

Job Summary

We are seeking an Eligibility Specialist for a temp-to-hire opportunity in Pleasanton, CA with a progressive third-party administrator supporting union health and welfare benefits. This role is ideal for a customer-focused professional with experience in the medical, insurance, benefits, or healthcare administration environment who enjoys detailed work, member support, and fast-paced daily operations.

The Eligibility Specialist will support enrollment processing, customer service calls, application handling, and administrative follow-up. This is a great opportunity to join a team-oriented environment where reliability, accuracy, professionalism, and a strong work ethic are valued. The organization offers a collaborative workplace, supportive leadership, and the potential for long-term career growth for the right candidate.

Key Responsibilities

• Answer incoming customer service calls and provide accurate, professional assistance to members, providers, and related contacts.
• Return calls and follow up on eligibility, enrollment, and application-related inquiries in a timely manner.
• Prepare enrollment packets and ensure required documents are complete, accurate, and ready for mailing or processing.
• Process applications and related eligibility materials according to established procedures and deadlines.
• Maintain organized records, track pending items, and support accurate administrative workflow.
• Assist with miscellaneous administrative duties and special projects as requested.

Compensation and Benefits

• Pay range: $32 to $36 per hour.
• Job type: Temp-to-hire.
• Location: Pleasanton, CA.

Required Qualifications and Skills

• Handle customer service calls and member inquiries related to eligibility, enrollment, and benefits administration.
• Prepare enrollment packets, mail applications, and process completed materials accurately and on time.
• Support daily administrative workflow in a fast-paced insurance, medical, or benefits environment.
• Maintain organized records, meet deadlines, and complete follow-up tasks with minimal supervision.
• 5 plus years of customer service experience, preferably in the medical, healthcare, insurance, benefits, or related industry.
• High school diploma required.
• Proficiency with Microsoft Word, Outlook, and Excel at an intermediate level.
• Ability to complete required Microsoft Office skill evaluations, including Word, Outlook, and Excel.
• Excellent written and verbal communication skills.
• Strong problem-solving skills with the ability to research issues and provide accurate information.
• Highly organized, accurate, and detail-oriented.
• Ability to prioritize work, manage multiple tasks, and remain productive with minimal supervision.
• Positive team player with a professional, courteous, and cooperative communication style.
• Able to work well under pressure while maintaining a helpful and customer-focused attitude.
• Proven reliability, strong attendance, and commitment to meeting deadlines.

Preferred Qualifications

• Associate degree or higher.
• Prior experience with union health and welfare benefits, third-party administration, eligibility processing, or enrollment administration.
• Experience supporting members, providers, or participants in a benefits or healthcare-related customer service environment.

Equal Opportunity Employer / Disabled / Protected Veterans

The Know Your Rights poster is available here: https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdf

The pay transparency policy is available here: https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf

For temporary assignments lasting 13 weeks or longer, AppleOne is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.

We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.

AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program. https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf

We also consider for employment qualified applicants regardless of criminal histories, consistent with legal requirements, including, if applicable, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records, including, if applicable, the San Francisco Fair Chance Ordinance. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.