Senior Eligibility Consultant

Senior Eligibility Consultant

Requirements

• 1-2 years of experience as an Eligibility Consultant
• Demonstrated proficiency in processing accurate and timely policy and eligibility data
• Ability to understand and meet intent/end state with minimal guidance

Responsibilities

• Process accurate and timely policy and eligibility data utilizing administration systems for claim payment purposes and product production, ensuring services and products meet plan sponsor needs
• Collaborate with business partners to understand enterprise initiatives and goals
• Respond to eligibility and other enrollment related issues
• Partner directly with clients, vendors, internal teams, and/or local claim operation to resolve problems and achieve positive outcomes
• Anticipate and prevent problems and roadblocks before they occur
• Solve complex problems and take a new perspective on existing solutions
• Design, develop, and deliver transitional training processes and procedures to smooth the transition for newly hired employees from formalized classroom training to the department’s production environment; mentor junior team members
• Assist with and/or evaluate recommendations involving eligibility reporting solutions and negotiate with internal/external clients
• Deliver consulting services in support of data discrepancies and/or involving reporting alternatives

Preferred Qualifications

• Ability to be in the East Lansing, MI or Plymouth, MN offices 3 days per week
• Coaches and mentors others
• Ability to manage multiple tasks and shifting priorities
• A team player capable of operating independently when needed
• Provides accurate and timely results
• Delegates and follows up as needed
• Ability to manage high work volume and oversee a variety of incoming workflows
• Drafting process documents
• Strong background in communication