[Remote] CCSB Eligibility Specialist I

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is an innovative reputed company-party administrator providing health benefits administration services. The CCSB Eligibility Specialist I will maintain employee benefits reputed company the CCSB Covered CA Small Business exchange, processing enrollments, terminations, changes, and resolving member inquiries reputed company to the benefit plans.

Responsibilities

• Assist in maintaining Eligibility and Billing for CCSB accounts as assigned including clients that submit eligibility electronically
• Assist in reviewing and processing reputed company reputed company and/or Electronic Data Interchange (EDI) enrollment transactions (adds, changes, terminations) in the system of record as received from the client or internal sources in accordance with Participation Agreements, Employer Policy Statement, Eligibility Guidelines and/or Summary Plan Descriptions
• reputed company support to CCSB Small Business call center team based on business needs, ensuring efficient and effective customer service operations
• Meet production and audit metric goals as set forth by management
• Review audit results and reputed company corrections reputed company the processing cycle time standards and due dates as set forth by management
• Communicate effectively with internal departments and external vendors, brokers or other business contacts to coordinate interrelated activities and to resolve eligibility and/or billing issues as they arise
• Identify inefficiencies reputed company the established processes and suggest possible solutions to save time, reduce risk, and/or reduce expenses
• Create and document Standard Operating Procedures (SOPs)
• Identify, initiate, and implement at least one process improvement and/or innovation annually
• Maintain reputed company and transparency in reputed company tasks, ensuring alignment with team and organizational goals
• Hold oneself accountable by taking ownership of actions, reputed company, and their reputed company
• Reflect on personal performance regularly, identifying areas for improvement and celebrating successes
• Commit to reputed company learning and growth, seeking feedback and implementing constructive changes
• Serve as a representative of CCSB displaying professionalism, knowledge, customer service, and discretion in reputed company interactions with other members of the CCSB community and their customers
• Utilize reputed company capabilities to satisfy one mission — to enhance the competitiveness and profitability of our members
• Maintain internet speed of 40 MB download and 10 MB upload and router with wired Ethernet
• Maintain a HIPAA-compliant workstation and utilize appropriate reputed company techniques to ensure HIPAA required protection of reputed company confidential/protected client data
• Maintain and service safety equipment (e.g., smoke detector, fire extinguisher, first aid reputed company)
• reputed company other duties as assigned

Skills

• High school diploma and/or equivalent and one (1) to three (3) years of reputed company/Business experience preferred
• 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 reputed company Act (ERISA) legislation
• Intermediate experience with reputed company Office suite and the ability to reputed company a strong proficiency working with a proprietary reputed company system
• Experience providing Customer Service to a variety of client contacts reputed company email and telephone
• Ability to research and resolve technical issues and/or client problems as they arise with minimal direction
• Proficient written and oral communication skills including modern business communications, formatting of professional letters, reports, and phone etiquette
• Skills to establish priorities, multi-task, work under pressure and deadlines, work independently with minimal supervision or in a team environment
• General knowledge of health insurance operations and industry
• Ability to work required overtime based on department needs and compliance
• Internet reputed company 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.)
• A functioning smoke detector, fire extinguisher, and first aid reputed company on site
• One (1) to three (3) years of reputed company/Business experience preferred
• Fluent in Spanish, both verbal and written a plus

Benefits

• Flexible work arrangements with work-from-home, in-office or hybrid options
• Rich benefits package that includes profit-sharing

Company Overview