Enrollment & Eligibility Services Assistant I - Office

Primary Responsibilities:

• Process standard enrollment applications and eligibility updates for active, COBRA, retiree, and disability coverage in accordance with plan rules.
• Review, verify, and validate dependent documentation (e.g., birth certificates, marriage licenses, guardianship forms) and update records under guidance.
• Handle routine qualifying life events (QLEs), COBRA enrollments, and generate standard self-pay notices.
• Support retiree transitions, including Medicare coordination and self-pay enrollment intake.
• Perform routine updates to carrier and vendor portals for enrollments, terminations, and demographic changes.
• Apply employer-submitted hours and demographic data to maintain accurate eligibility records.
• Assist with nightly batch processing of rosters, terminations, and reinstatements.
• Conduct outreach to members and employers to collect missing or incomplete documentation, including for dependent verification.
• Follow up with employers regarding late or missing hours files and contribution payments as part of the delinquency tracking process.
• Respond to standard inquiries from members, HR departments, and employers regarding eligibility status, documentation, and plan rules.
• Assist with open enrollment processing, including intake, verification tracking, and updates.
• Support employer onboarding efforts by assisting with portal use and file submission protocols under supervision.
• Maintain compliance with HIPAA and internal privacy standards in all communications and record handling.
• Assist with audit preparation, eligibility reporting, and data cleanup projects as directed.
• Escalate complex or unclear eligibility issues or employer data discrepancies to the Team Lead or Management.

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