Health Plan Enrollment Specialist

Beacon Hill; 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

Position Overview

Our client, a nonprofit organization, is seeking a Health Plan Enrollment Specialist to support participant eligibility and health coverage administration. This role will assist participants with coverage questions, maintain eligibility records, coordinate with insurance providers, and support enrollment, COBRA, retiree, and dependent coverage processes.

Key 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.

Qualifications

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

Beacon Hill is an equal opportunity employer and individuals with disabilities and/or protected veterans are encouraged to apply.

California residents

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.

Company Profile

Founded by industry leaders to set a new standard in search, career placement and flexible staffing, we deliver coordinated staffing solutions with unparalleled service, a commitment to project completion and success and a passion for innovation, creativity and continuous improvement.

Our niche brands offer a complete suite of staffing services to emerging growth companies and the Fortune 500 across market sectors, career specialties/disciplines and industries. Over time, office locations, specialty practice areas and service offerings will be added to address ever changing constituent needs.

Learn more about Beacon Hill and our specialty divisions, Beacon Hill Associates, Beacon Hill Financial, Beacon Hill HR, Beacon Hill Legal, Beacon Hill Life Sciences and Beacon Hill Technologies by visiting www.bhsg.com.

Benefits Information

Beacon Hill offers a robust benefit package including, but not limited to, medical, dental, vision, and federal and state leave programs as required by applicable agency regulations to those that meet eligibility. Upon successfully being hired, details will be provided related to our benefit offerings.

We look forward to working with you.

Beacon Hill. Employing the Future