Enrollment & Eligibility Services Assistant I - Office

MagnaCare; Las Vegas (NV); On-site; USD 42,000 - 64,000; Full time

Job summary

MagnaCare is seeking an Enrollment Specialist in Las Vegas to process standard enrollment applications and manage eligibility updates for active, COBRA, retiree, and disability coverage.

You will review documents, handle life events, and coordinate with employers and members while maintaining HIPAA compliance and accurate records. This role requires attention to detail and reliable communication with HR departments and providers.

Responsibilities

• Process standard enrollment applications and eligibility updates for active, COBRA, retiree, and disability coverage in accordance with plan rules.
• Review, verify, and validate dependent documentation (e.g., birth certificates, marriage licenses, guardianship forms) and update records under guidance.
• Handle routine qualifying life events (QLEs), COBRA enrollments, and generate standard self-pay notices.
• Support retiree transitions, including Medicare coordination and self-pay enrollment intake.
• Perform routine updates to carrier and vendor portals for enrollments, terminations, and demographic changes.
• Apply employer-submitted hours and demographic data to maintain accurate eligibility records.
• Assist with nightly batch processing of rosters, terminations, and reinstatements.
• Conduct outreach to members and employers to collect missing or incomplete documentation, including for dependent verification.
• Follow up with employers regarding late or missing hours files and contribution payments as part of the delinquency tracking process.
• Respond to standard inquiries from members, HR departments, and employers regarding eligibility status, documentation, and plan rules.
• Assist with open enrollment processing, including intake, verification tracking, and updates.
• Support employer onboarding efforts by assisting with portal use and file submission protocols under supervision.
• Maintain compliance with HIPAA and internal privacy standards in all communications and record handling.
• Assist with audit preparation, eligibility reporting, and data cleanup projects as directed.
• Escalate complex or unclear eligibility issues or employer data discrepancies to the Team Lead or Management.

Job description

Primary Responsibilities:

• Process standard enrollment applications and eligibility updates for active, COBRA, retiree, and disability coverage in accordance with plan rules.
• Review, verify, and validate dependent documentation (e.g., birth certificates, marriage licenses, guardianship forms) and update records under guidance.
• Handle routine qualifying life events (QLEs), COBRA enrollments, and generate standard self-pay notices.
• Support retiree transitions, including Medicare coordination and self-pay enrollment intake.
• Perform routine updates to carrier and vendor portals for enrollments, terminations, and demographic changes.
• Apply employer-submitted hours and demographic data to maintain accurate eligibility records.
• Assist with nightly batch processing of rosters, terminations, and reinstatements.
• Conduct outreach to members and employers to collect missing or incomplete documentation, including for dependent verification.
• Follow up with employers regarding late or missing hours files and contribution payments as part of the delinquency tracking process.
• Respond to standard inquiries from members, HR departments, and employers regarding eligibility status, documentation, and plan rules.
• Assist with open enrollment processing, including intake, verification tracking, and updates.
• Support employer onboarding efforts by assisting with portal use and file submission protocols under supervision.
• Maintain compliance with HIPAA and internal privacy standards in all communications and record handling.
• Assist with audit preparation, eligibility reporting, and data cleanup projects as directed.
• Escalate complex or unclear eligibility issues or employer data discrepancies to the Team Lead or Management.