Eligibility & Enrollment Specialist

Enrollment & Eligibility Database Specialist

Benefit Management Administrators, Inc. (BMA) is a Third- Party Administrator (TPA) that services Employers and Health Insurance Brokers by administering COBRA, Flexible Spending, Dependent Care, Health Reimbursement & Medical Reimbursement Accounts.  We have an immediate opening for an Enrollment & Eligibility Database Specialist to assist us in delivering these services.

JOB DESCRIPTION:

The Enrollment & Eligibility Database Specialist serves as an Implementation Team Member Expert that will be processing data to maintain and update members and other systems. This position is accountable for reviewing claims for Flexible Spending/DCA/MERP/HRA accounts for the purpose of applying appropriate IRS guidelines/benefits and policies. Will also be responsible for processing COBRA event information according to guidelines, incoming/outgoing correspondence, and receive incoming calls from participants. This position requires the ability to work independently, assess situations quickly and make logical and appropriate decisions with attention to detail and a service mentality for both internal and external customers. The Enrollment & Eligibility Database Specialist will be able to complete their assigned tasks accurately and timely exhibiting a Culture of Professionalism at all times.

QUALIFICATIONS & KNOWLEDGE REQUIREMENTS:

• Processing EDI files – working errors, resolving formatting issues & testing file fixes.
• Process COBRA and FSA event information according to guidelines.
• Proficient PC skills with strong knowledge of various software applications, Excel Formulas used in a business environment (MS Office, Excel, Internet, Exchange/Outlook, etc.)
• Knowledge of Group Benefit Plans, Medical Terminology and ICD9/CPT/HCPC codes.
• Experience working with Confidential Information.
• Process carrier new Client and Benefit Enrollments via all media.
• Process Evidence of Insurability (EOI) requests and approvals.
• Process Error and Discrepancy reports.
• Ability to quickly become familiar with and maintain existing applications.
• Ability to translate business requirements into technical specifications.
• Ability to produce finished applications under deadline.
• Perform other duties as required to ensure the efficient and effective functioning of the organization and/or work units within.

EDUCATION & LICENSING:

• Bachelor's Degree or Equivalent.
• Insurance Licensing a Plus.

EXPERIENCE LEVEL:

• A minimum of 5 years' experience in Database Administration and/or Enrollments & Eligibility is required.