Billing & Eligibility Specialist - Nashville - Hybrid/Remote

Job Description

Job Description

About Lucent Health

Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers.

Company Culture

We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health.

Honest

• Transparent Communication: be open and clear in all interactions without withholding crucial information
• Integrity: ensure accuracy in reporting, work outputs and any tasks assigned
• Truthfulness: provide honest feedback and report any issues or challenges as they arise
• Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior

Ethical

• Fair Decision Making: ensure all actions and decisions respect company policies and values
• Accountability: own up to mistakes and take responsibility for rectifying them
• Respect: treat colleagues, clients and partners with fairness and dignity
• Confidentiality: safeguard sensitive information and avoid conflicts of interest

Hardworking

• Consistency: meet or exceed deadlines, maintaining high productivity levels
• Proactiveness: take initiative to tackle challenges without waiting to be asked
• Willingness: voluntarily offer to assist in additional projects or tasks when needed
• Adaptability: work efficiently under pressure or in changing environments

Summary :

The Billing/Benefits Eligibility Specialist is a key part of the department’s successful operation. The specialist is in daily contact with members, clients, and providers, and therefore needs to be a cheerful, competent and compassionate representative Lucent Health. The position is responsible to assess, interpret and process incoming eligibility feeds through all possible correspondence venues. This includes but is not limited to Cobra requests, Eligibility File Audits, Individual paper eligibility forms and all other potential eligibility inquiries and forms. Attendance can also directly impact the satisfaction level of our clients and retention of our accounts.

Responsibilities

• Administer and coordinate the day-to-day operations of the COBRA functions to ensure timely and accurate processing of groupand individual COBRA updates.
• Manage COBRA enrollments, terminations, and premium payment updates through our internal systems.
• Respond to COBRA-related inquiries from former employees, beneficiaries, and insurance carriers.
• Stay current with COBRA regulations, ERISA,HIPAAand ACA compliance requirements.
• Coordinate with clients on plans that Lucent does not administer but does administer COBRA for such plans to update outside carriers accordingly with COBRA elections, terms, and changes.
• Generate COBRA reports weekly out of networkingsystem.
• Perform all functions of the B&E role for assigned case load.

Qualifications

• 3–5 years of experience in benefits administration within a TPA or health plan environment; experience with self-funded plans with focus on COBRA management.
• Strong understanding of COBRA, HIPAA, ERISA, and ACA regulations.
• Excellent analytical, organizational, and communication skills with strong attention to detail.
• Proficiency in benefit administration systems, data analysis tools, and Microsoft Office applications.

Equal Employment Opportunity Policy Statement

Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.