Health Plan Enrollment Specialist

Job Description

Job Description

We are looking for a positive and highly motivated individual to become an integral part of our Healthcare Enrollment team. The ideal candidate will be detail-oriented, quality-focused, and able to retain and build on a wealth of information related to Healthcare Enrollment. Excellent communication, computer and problem-solving skills, and a willingness to dig in and work alongside the other members of the department and with other departments are crucial.

The Healthcare Enrollment Specialist I is responsible for incoming member service calls and assists with enrollment and eligibility questions for a variety of clients for a full range of Health & Welfare Benefits; you will need to be both attentive to the needs of those enrolling but also to the details and documentation involved throughout the process while following up on ongoing issues to resolution.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

• Serve as the primary point of contact for members, providing timely and accurate responses to inquiries regarding benefits, eligibility, and claim status.
• Navigate multiple computer portals and tools simultaneously to process enrollments, verify eligibility, and manage information efficiently.
• Maintain a working knowledge of various benefit plans and accurately process member enrollments, ensuring compliance with plan rules. Strict adherence to standard operating procedures.
• Address and resolve member issues using common sense and a solutions-focused approach, escalating complex issues as needed.
• Maintain detailed records of member interactions and actions taken to ensure accurate and complete documentation.
• Work closely with team members to ensure seamless service delivery and support across all client accounts.
• Exhibit a professional, positive demeanor, and contribute to a supportive, solutions-oriented approach, ensuring that the team’s focus remains on providing exceptional service.
• Other tasks and duties as assigned by management.

The ideal candidate will be very organized and detailed, as well as diligent, responsive, takes initiative, and works well both independently and with others, and maintains NEBA’s culture and focus on top member care.

OTHER FUNCTIONS

Member Enrollment and other processing assistance, as well as backup for ingoing and outgoing mailings.

Review and maintain incoming documents for validity and keep the database current.

Backup team members as needed.

Adapt to evolving needs and to take on additional tasks as necessary to ensure the smooth operation of the department.

A positive attitude and willingness to go above and beyond are key to success in this position.

Strong customer service skills with the proven ability to actively listen, remain professional under pressure with the ability to de-escalate members by providing empathy and “I can do” attitude.

Takes ownership of member’s issues and responsibility to use tools and resources to serve members and solve problems consistently and timely. Proficient in using computers and comfortable navigating multiple software tools; Typing 35-45 WPM, Excel basic functions.

Ability to manage time effectively in a fast-paced environment with a high volume of inquiries.

Team-oriented with a collaborative attitude and a commitment to fostering a positive work environment.

Flexibility to adapt to the needs of different clients and shifting priorities.

EDUCATION AND / OR EXPERIENCE

High School Diploma or Equivalent.

Minimum of 2 years of administrative experience in a similar field.

Experience in healthcare or insurance is strongly preferred.

KNOWLEDGE, SKILLS, AND ABILITIES

Strong data entry skills.

Strong analytical skills.

Proven ability to collaborate with teammates.

Proficiency in time management and following processes.

Excellent problem-solving skills.

PHYSICAL DEMANDS

The physical demands described here are representative of those an individual must meet in order to successfully perform the essential functions of this job. We will make reasonable accommodations to enable individuals with disabilities to perform these functions.

Ability to sit for extended periods of time and to move intermittently throughout the workday.

Strong sensory skills, such as good eyesight, good hearing, and dexterity. Good speaking and listening skills.

Ability to perform focused work with close attention to detail.

Ability to operate office equipment, including computers, copiers, fax machines, and phones.

Ability to interact with others, both in person and through phone, e-mail, and written correspondence.

Ability to lift up to 15 pounds.

LOCATION

This is a full-time position based in-office. The typical work schedule is Monday through Friday 8 : 00am-5 : 00pm EST.

About NEBA

National Employee Benefits Administrators, Inc. (NEBA) is a family-owned corporation that has been in business since 1994. We specialize in the administration of Taft-Hartley benefit plans. Since the day we opened our doors, we have been signatory to a Collective Bargaining Agreement with United Food and Commercial Workers (UFCW) Local 1625.

NEBA is headquartered in Pembroke Pines, Florida, a suburb of Miami. We have satellite office locations in Jacksonville, Florida and Atlanta, Georgia. We also have a number of onsite offices at client locations.

NEBA is an Equal Opportunity Employer committed to hiring a diverse work team.

Why work at this company?

Awesome leadership team, great benefits (medical, dental, vision, life insurance, and pension), family-oriented, strong appreciation of work / life balance, opportunities for professional development and advancement.

Job Type : Full-time

Benefits :

401(k)

Dental insurance

Employee assistance program

Health insurance

Life insurance

Paid time off

Vision insurance

Schedule :

8 hour shift

Monday to Friday

Experience :

Health Insurance : 1 year (Preferred)

Customer service : 1 year (Required)

Benefits administration : 1 year (Preferred)

Language :

Spanish (Required)

Ability to Commute :

Pembroke Pines, FL 33028 (Required)

Work Location : In person

Company Description

NEBA is a Third Party Administrator that supports the hardworking members of the Taft-Hartley community that are the backbone of our country. We perform administrative services to members regarding their health and retirement plans and encourage candidates to review our website for an overview of what we do. www.nebainc.com.

Company Description

NEBA is a Third Party Administrator that supports the hardworking members of the Taft-Hartley community that are the backbone of our country. We perform administrative services to members regarding their health and retirement plans and encourage candidates to review our website for an overview of what we do. www.nebainc.com.