Enrollment & Benefits Eligibility Specialist

Zenith American Solutions, Inc.; La Cañada Flintridge (CA); On-site; USD 34,000 - 38,000; Full time

Job summary

Zenith American Solutions is seeking an Eligibility & Enrollment Processor to support enrollment operations, maintain accurate member records, and assist with related inquiries. You will help ensure enrollment data is processed accurately and provide timely documentation to members and stakeholders.

The role includes access to PHI/PII as described by the job duties, with a focus on efficient administration and coordination with internal teams and external partners.

Qualifications

• High School diploma or equivalent.
• Minimum 6 months general office experience with demonstrated dependability.
• Strong work ethic and team player mentality.
• Ability to communicate clearly and professionally, both verbally and in writing.
• Solid organization skills with strong attention to detail and listening skills.
• Proficient in MS Office applications.

Responsibilities

• Maintains current knowledge of assigned Plan(s) and applies knowledge in all job functions.
• Provides written, verbal, or face-to-face customer service by responding to inquiries and documenting them per plan benefits.
• Maintain member and dependent files in the administration system.
• Resolve eligibility & enrollment issues with various vendors (PPOs, PBMs, etc.).
• Handle inbound and outbound correspondence, such as ID cards and eligibility packets.
• Researches and resolves complex and technical issues and irregularities.
• Respond to inquiries from examiners and billing processors concerning enrollment issues.
• Perform other job related duties as assigned.

Job description

Zenith American Solutions is seeking an Eligibility & Enrollment Processor to support enrollment operations, maintain accurate member records, and assist with related inquiries. You will help ensure enrollment data is processed accurately and provide timely documentation to members and stakeholders.

The role includes access to PHI/PII as described by the job duties, with a focus on efficient administration and coordination with internal teams and external partners.