Health Coverage Navigator & Enrollment Specialist

Beacon Hill Staffing Group; California; On-site; USD 52,000 - 76,000; Full time

Job summary

Beacon Hill Staffing Group is seeking a Health Plan Enrollment Specialist to support participant eligibility and health coverage administration. You will assist participants with coverage questions, maintain eligibility records, and coordinate with insurance providers to manage enrollment, COBRA, retiree and dependent coverage.

The role emphasizes accuracy, analytical thinking and strong communication skills to ensure compliant and timely coverage updates.

Qualifications

• Bachelor's degree or equivalent preferred.
• 2-3 years in customer service in group health insurance preferred.
• Excellent written and verbal communication.
• Strong analytical and mathematical skills.
• Excellent organizational skills with attention to detail.
• Proficiency in Microsoft Word and intermediate knowledge of Excel.
• Ability to prioritize workload and meet deadlines.

Responsibilities

• Respond to participant and representative inquiries regarding eligibility and health coverage.
• Assist with the open enrollment process.
• Maintain participant and dependent eligibility records, including additions, terminations, reinstatements, and coverage changes.
• Coordinate with insurance providers to update participant and dependent coverage.
• Process and establish coverage for retirees, divorced spouses, and surviving spouses.
• Set up COBRA and self-pay coverage when applicable.
• Monitor vendor eligibility discrepancy reports and resolve coverage issues.
• Review and follow up on dependent documentation, Coordination of Benefits, and other eligibility requirements.
• Prepare correspondence related to eligibility issues and required documentation.
• Reconcile vendor invoices and premiums and process applicable refunds.
• Review eligibility appeals involving premiums, dependent additions, coverage changes, COBRA events, and open enrollment.
• Perform reconciliations related to the Retiree Drug Subsidy (RDS), Medicare Drug Subsidy program, and CMS Section 111.

Skills

Customer service

Communication skills

Attention to detail

Analytical skills

Microsoft Word

Excel

Education

Bachelor's degree preferred

Tools

Microsoft Word

Excel

Job description

Beacon Hill Staffing Group is seeking a Health Plan Enrollment Specialist to support participant eligibility and health coverage administration. You will assist participants with coverage questions, maintain eligibility records, and coordinate with insurance providers to manage enrollment, COBRA, retiree and dependent coverage.

The role emphasizes accuracy, analytical thinking and strong communication skills to ensure compliant and timely coverage updates.