ELIGIBILITY TRAINEE

Job Description

Job Description

Position : Eligibility Specialist- Trainee Range : 0301

Revised : 2021

Job :

Under direct supervision of the Department Supervisor, Eligibility Lead, or Senior Data Eligibility Specialist, this is an in-training capacity to determine suitability for Eligibility verification work.

Job Duties :

Learn basic rules of eligibility and computer systems for verification of eligibility.

Use customer service skills, both written and telephonic, to provide helpful information, answer questions and resolve complaints.

Complete written and verbal verification of Eligibility.

Work with and understand COBRA, HIPAA and FMLA Laws and compliance requirements including all participant notification requirements.

Process COBRA election forms.

Process death claims.

Process enrollment / beneficiary forms and other documents used for maintaining member records.

Order medical I.D. cards.

Update participant and dependent eligibility with insurance carriers as required.

Research and resolve member and dependent eligibility issues.

Must show continuous improvement and ability to increase volume of workload and ability to work independently, and as a productive team member.

Perform other duties as assigned

Minimum qualifications :

Working knowledge of basic office equipment

Professional appearance with excellent communication skills required, both verbal and written, including the ability to communicate effectively with the public, union representatives, outside agencies, insurance carriers and employers.

Requires a dependable attendance record.

Demonstrates initiative along with good concentration, attention to detail and problem-solving abilities.

Requires excellent organizational skills and the ability to multi-task.

Demonstrates ability to keep calm and positive within all communications.

Proven ability to accurately and timely review and edit documents.

1 year of general office experience

Utilize computer and phone systems to be able to effectively perform the essential functions of the position.

Previous experience utilizing Microsoft office software

High school diploma or G.E.D

This is a progressive position with reclassification to "Eligibility Specialist" commensurate with the ability to perform as described by that position title, including basic knowledge of eligibility, teleprocessing systems for verification of eligibility.

Preferred qualifications

1 years of office experience in a high call volume environment

2 years of college experience in a related field- do not have to have an associate degree

Physical / Mental requirements :

The physical and mental demands described here are representative of those that must be met by employees to successfully perform the essential functions of this job.

While performing the duties of this job, employees are regularly required to use written and oral

• communication skills; read and interpret data, information and documents; analyze and solve non-routine and complex office administrative problems;
• use math and mathematical reasoning; observe and interpret situations; learn and apply new information or skills; perform highly detailed work on multiple, concurrent tasks;

work under intensive deadlines with frequent interruptions

Work environment :

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this class.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Employees work under typical office conditions, and the noise level is usually quiet.

WPAS is an equal opportunity employer. We celebrate diversity and strive to continually create the most inclusive work environment for all our employees.