Eligibility Specialist (Hybrid)

Eligibility Specialist

About Patriot Growth Insurance Services: Founded in 2019, Patriot is a growth-focused national insurance services firm that partners with employee benefits and property and casualty agencies across the United States. Patriot is currently ranked as the 25th largest broker in the U.S. by Business Insurance and has been named to the 2025 Inc. 5000 list of fastest-growing companies. With over 2,100 employees operating in 150+ locations in over 45 states, Patriot's collaborative model delivers resources and strategic support to its agencies. Patriot creates true alignment with its partner agencies, and its operating philosophy fosters enhanced career opportunities for its dedicated and professional team. We are committed to working with like-minded individuals who share our vision of creating an insurance agency focused on operational excellence and a relentless pursuit of growth.

Position Overview: We are seeking a detail-oriented and organized Eligibility Specialist to support employee benefits eligibility and enrollment administration across a growing client base. This role is responsible for managing the end-to-end eligibility process, including new hires, terminations, qualifying life events, open enrollment activity, and ongoing employee membership changes. The ideal candidate is highly responsive, experienced in benefits administration processes, and comfortable working across multiple carrier and vendor systems in a fast-paced environment. This position plays a key role in ensuring accurate enrollment processing, maintaining compliance, and delivering exceptional support to clients and internal teams.

Work Arrangement: This is a full-time hybrid position working in our office located in Dallas, TX.

Professional Responsibilities:

• Manage open enrollment and ongoing enrollment activity received through eligibility inboxes and internal or external channels, including new hires, terminations, qualifying life events, evidence of insurability, and COBRA-related updates.
• Process and submit enrollment, change, and termination documentation to carriers through carrier portals, email, fax, automated feeds, and other approved submission methods.
• Monitor carrier submissions and proactively follow up to ensure timely and accurate processing of employee eligibility transactions.
• Maintain accurate eligibility records and ensure all documentation is compliant with carrier requirements, agency procedures, and applicable regulations.
• Conduct regular audits of enrollment and eligibility data to ensure accuracy and alignment between internal systems, carriers, and vendor platforms.
• Review and reconcile carrier invoices, identify discrepancies, and coordinate resolution efforts with carriers, clients, and internal teams.
• Review, reconcile, and resolve discrepancies identified through 834 eligibility file feed reports to maintain accurate employee enrollment data across systems.
• Generate enrollment, eligibility, and reporting documentation to support internal operations and client service needs.
• Perform general data entry, maintenance, and system clean-up activities within agency systems such as ZyWave, BenefitPoint, SharePoint, and related platforms.
• Navigate and execute task assignments within benefit administration systems including Employee Navigator, ADP, Paycom, and similar platforms.
• Serve as a liaison between clients, carriers, vendors, Account Managers, and Producers to resolve enrollment, eligibility, and billing-related issues.
• Maintain organized and accurate documentation within agency systems including BenefitPoint, Keeper, OneDrive, and other internal systems.
• Follow established workflows, procedures, and documentation standards to support operational consistency and compliance.
• Stay current on carrier requirements, agency systems, benefits technology, and industry best practices related to enrollment administration and employee benefits operations.

Qualifications and Requirements:

• 1-3 years of experience in a professional environment handling confidential and sensitive information, preferably within employee benefits, insurance, or human resources.
• Active Life & Health Insurance License required.
• High school diploma/GED or Associate Degree in Business Administration, Human Resources, or a related field required.
• Bachelor's degree in Business Administration, Human Resources, or a related field preferred.
• Experience in employee benefits insurance, benefits administration, or human resources preferred.
• Strong organizational skills with the ability to manage multiple priorities, deadlines, and detailed administrative processes effectively.
• Excellent written and verbal communication skills with the ability to communicate clearly and professionally with clients, carriers, and internal teams.
• Demonstrated ability to quickly learn and navigate multiple carrier portals, vendor platforms, and benefits administration systems.
• Strong problem-solving skills with a proactive and detail-oriented approach to issue resolution.
• Proficiency with Microsoft Office Suite, CRM systems, Agency Management Systems, and employee benefits technology platforms.
• Collaborative mindset with the ability to work effectively within a team-oriented environment.
• Commitment to maintaining confidentiality and handling sensitive employee and client information with professionalism and discretion.

Why Patriot Growth Insurance Services: We offer the opportunity to be a part of one of the fastest-growing insurance companies since its inception. We strive to create a flexible and collaborative environment for our employees, and our goal is to provide enhanced career opportunities for our dedicated and professional team. In addition to a competitive salary, we provide a comprehensive health and welfare program to employees, family members and domestic partners. Employees are eligible for benefits coverage the first of the month following 30 days of employment. We offer:

• Medical, Dental, and Vision Benefits
• Flexible Spending Account (FSA) and Health Savings Account (HSA) and Commuter Transit Programs
• Company paid Short-Term Disability, Long-Term Disability and Group Term Life
• Company paid Employee Assistance Program
• Paid Parental Leave
• Paid holidays
• Personalized PTO
• 401 (k)

Patriot Growth Insurance Services is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, citizenship or immigration status, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.

This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, leave of absence, compensation, benefits, and training. Patriot makes hiring decisions based solely on qualifications, merit, and business needs at the time. For more information, read through our EEO and DE&I Policy located on our website.