Eligibility Specialist

Eligibility Specialist (TEMP), 100% remote

The Eligibility Specialist reports to the Administrative Services Supervisor. This position maintains updated enrollment and benefit information for all self-insured employer groups.

Basic Qualifications

• 1-2 yrs of Eligibility experience
• 1-2 yrs of EDI experience

Principal Duties And Responsibilities

• Answer telephone inquiries from insured members, employers, providers, etc., regarding enrollment and prescription issues.
• Process EDI Member Maintenance on a daily basis.
• Oversee the process of benefit additions, changes and deletions in the GBAS system within 24 hours of receipt.
• Manage the process of benefit additions, changes and deletions in the GBAS system.
• Oversee the process of prescription drug benefits additions, changes and deletions with Pharmacy Benefit Managers.
• Coordinate the printing and mailing of health ID cards to insured members.
• Provide COBRA administration for self-insured groups who request the service.
• Respond to HIPAA certificate requests.
• Run eligibility reports as needed.
• Participate in audits as needed.
• Notify management of overtime needs by completing appropriate forms.
• Perform other duties as assigned.

General Expectations

• Present a positive image at all times.
• Provide and promote the delivery of services with a prevailing attitude of respect and recognition of the personal worth and dignity of every individual whether they are a customer or coworker.
• Communicate in a clear and concise manner, while also demonstrating receptivity through active listening.
• Identify and perform work that has not been specifically assigned, as needed.
• Adheres to established safety standards and utilizes proper techniques to avoid work-related injuries.
• Continuously seek opportunities for improvement and suggest ways in which procedures/systems may be modified to accomplish tasks/goal efficiently and effectively.
• Demonstrate a teamwork philosophy by working cooperatively with others inside and outside the Administration Division.
• Attend required in-service and staff meetings.
• Preserve the confidentiality of all business-sensitive information, including but not limited to that of insured groups and individuals, employees and applicants.

Knowledge, Skills And Ability Requirements

• High School Education Required.
• Previous experience working in the insurance or benefits management field.

Physical And Mental Abilities

• Ability to perform sedentary work for extended periods of time.
• Ability to utilize personal computer (manual dexterity is required to operate a keyboard), telephone system, and communicate with a variety of customers.
• The environment in which the incumbent will work requires the ability to concentrate, meet deadlines, work on several projects during the same period, and adapt to interruptions.

Reporting Structure/Supervision

• Reports to the Administrative Services Supervisor.

Working Conditions

• Work is performed in a normal office environment.
• Overtime as needed may be requested.

About NTT DATA

NTT DATA is a $30+ billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize, and transform for long-term success. We invest over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure, and connectivity. We are also one of the leading providers of digital and AI infrastructure in the world. NTT DATA is part of NTT Group and headquartered in Tokyo. Visit us at us.nttdata.com

NTT DATA is an equal opportunity employer and considers all applicants without regard to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.

Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting range for this remote role is ($18.50 - 19.00 per hour). This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.

This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits.

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