Eligibility Specialist II

Job Description

Johnson Service Group (JSG) is seeking an Eligibility Specialist.

Remote- Candidates must live in California.

Work Schedule : Monday - Friday (8 : 00am- 5 : 00pm)

Hourly pay : $18.75

Job Description Summary

This position reports to the Supervisor I, Enrollment and Eligibility. The Covered CA for Small Business (CCSB) Eligibility Specialist II is responsible for determining and managing the eligibility of employees for various benefits programs within the CCSB exchange. This role involves evaluating employee eligibility, processing benefits enrollments and terminations, and providing support to employees regarding their benefits options. The incumbent ensures compliance with company policies and legal regulations.

Qualifications

• High School diploma or equivalent and / or three (3) to five (5) years of accounting / business experience preferred.
• Intermediate knowledge of generally accepted health care eligibility and billing procedures as well as Health Insurance Portability and Accountability Act (HIPAA), Consolidated Omnibus Budget Reconciliation Act (COBRA), California Continuation Benefits Replacement Act (Cal-COBRA) and Employee Retirement Income Security Act (ERISA) legislation.
• Proficient experience with Microsoft Office Suite.
• Proficiency in HR and benefits management software preferred.
• Strong knowledge of processing Electronic Data Interchange (EDI) file updates in a legacy system.
• Experience providing customer service to a variety of client contacts via email and telephone.
• Demonstrated ability to research and resolve technical issues and / or client problems as they arise with minimal direction.
• Written and oral communication skills including modern business communications, formatting of professional letters, reports, and phone etiquette.
• Demonstrated time management skills including, multi-tasking, working under pressure and deadlines, and working independently with minimal supervision or in a team environment.
• Intermediate knowledge of health insurance operations and industry.
• Fluent in Spanish, both verbal and written a plus.
• Ability to work overtime based on department needs and compliance.
• Internet access provided by a cable or fiber provider with 40 MB download and 10 MB upload speeds.
• Home router with wired Ethernet (wireless connections and hotspots are not permitted).
• A designated room for your office or steps taken to protect company information (e.g., facing computer towards wall, etc.)

Duties And Responsibilities

Team Development

Department Operations

Process Improvement & Cost Containment

Monitor and communicate to management processes deficiencies and recommended solutions.

JSG offers medical, dental, vision, life insurance options, short-term disability, 401(k), weekly pay, and more. Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law. #D800