Billing and Eligibility Representative

Requirements

• Self-motivated with the ability to work independently and as part of a team.
• Comfortable working in a fast-paced, deadline-driven environment.
• Customer-service mindset with a solution-oriented approach.
• Please see our company Benefits:
• Medical, Dental, Vision
• Life Insurance and AD&D
• FSA / HSA
• Accident
• Critical Illness
• Hospital Indemnity
• Supplemental Health Insurance
• EAP
• Pet Insurance
• 11 Paid Holidays
• Flexible PTO
• 401K

Benefits

Additional Information

We are seeking a detail-oriented and dependable Billing & Eligibility Representative to join our Third-Party Administrator (TPA) team. This role supports the Billing and Eligibility Manager and our clients by managing eligibility data, billing functions, COBRA administration support, invoicing, and reporting. The ideal candidate is organized, collaborative, and eager to learn. Training will be provided for the right candidate. Maintain, update, and manage employee enrollment and eligibility files with accuracy and timeliness. Process and track eligibility changes, including new enrollments, terminations, qualifying events, and status updates. Assist with COBRA eligibility updates and administrative support. Compile and maintain eligibility reports for internal teams and clients. Download, review, and process eligibility and billing data files from vendor systems. Communicate professionally with internal departments, vendors, and clients to resolve billing and eligibility issues. Ensure data integrity and compliance with applicable regulations. Perform additional duties and special projects as assigned. Basic knowledge or understanding of benefits enrollment and eligibility processes. Familiarity with COBRA and HIPAA regulations is preferred. Strong proficiency in Microsoft Office, including Excel, Word, and Outlook. High attention to detail with strong data accuracy skills. Excellent organizational, time management, and problem-solving abilities. Strong interpersonal and communication skills; comfortable working with both internal teams and external clients. Ability to handle sensitive and confidential information with professionalism. Willingness and ability to learn new systems and processes; training will be provided.

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