Health Plan Enrollment Specialist II

Job Description

Job Description

Job Overview
National Employee Benefits Administrators, Inc. (NEBA) is a full service, licensed Third Party Administrator providing benefit administration services to health, retirement and other benefit plans.

We are seeking a dedicated and detail-oriented Enrollment Specialist to join our team. The Enrollment Specialist will be responsible for providing exceptional service to members by handling Health Plan enrollment applications, verifying eligibility, and supporting members through the enrollment process. This role involves a combination of processing member applications and assisting members over the phone. The ideal candidate is detail-oriented, adaptable, and committed to delivering a positive experience for members navigating their health and welfare benefits.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

To be successful in this role, you will need to be able to perform in a professional manner the skills listed below. We will make accommodations anywhere possible to enable individuals with disabilities to perform these functions, so long as such accommodations exist.

ESSENTIAL FUNCTIONS

• Serve as the primary point of contact for members, assisting with benefit inquiries, enrollment, and eligibility verification.
• Provide timely, accurate, and empathetic support to members, ensuring they understand their benefit options and the enrollment process.
• Handle inbound and outbound calls, including resolving member concerns, escalating complex issues as needed, and following up to ensure resolution.
• Educate members on their plan options, enrollment deadlines, and any required documentation.
• Maintain professional and courteous communication, ensuring a positive member experience.
• · Process new enrollments, status changes, and terminations while ensuring compliance with plan policies and procedures.
• Review and validate submitted documents, ensuring accuracy and completeness before updating member records.
• Navigate multiple software systems to enter, track, and manage enrollment information efficiently.
• Maintain up-to-date knowledge of various health and welfare plans, eligibility rules, and documentation requirements.
• Follow standard operating procedures (SOPs) and best practices to ensure accurate data entry and record-keeping.

• OTHER FUNCTIONS
• Work closely with internal teams to resolve member issues, share insights, and enhance service delivery.
• Serve as a backup for mailing and other administrative functions when needed.
• Contribute to a positive and solutions-focused team environment.
• Perform additional duties as assigned to support operational efficiency and improve member experience.

EDUCATION AND/OR EXPERIENCE

To perform this job successfully, an individual must have the following education and/or experience.

• High school diploma or equivalent
• Minimum of 1 years of experience in benefits administration, healthcare, insurance, or a related field.
• Experience in a call center or customer service role, with a focus on benefits or enrollment preferred.
• Experience handling sensitive information and working in compliance-driven environments.

KNOWLEDGE, SKILLS, AND ABILITIES

The requirements listed below are representative of the knowledge, skills, and/or abilities required to perform each essential duty satisfactorily. We will make reasonable accommodations to enable individuals with disabilities to perform these functions.

• Strong customer service skills with the ability to actively listen, de-escalate concerns, and provide solutions.
• Strong attention to detail and ability to follow compliance guidelines for enrollment processing.
• Professional and empathetic communication skills, both verbal and written.
• · Ability to work independently and as part of a team, demonstrating initiative and adaptability.
• Working knowledge of Microsoft Office.
• Experience with data entry, document creation, and spreadsheet management.
• Bilingual/ Spanish speaking required.

PHYSICAL DEMANDS

The physical demands described here are representative of those an individual must meet in order to successfully perform the essential functions of this job. We will make reasonable accommodations to enable individuals with disabilities to perform these functions.

• Ability to sit for extended periods of time and to move intermittently throughout the workday.
• Strong sensory skills, such as good eyesight, good hearing, and dexterity.
• Good speaking and listening skills.
• Ability to perform focused work with close attention to detail.
• Ability to operate office equipment, including computers, copiers, fax machines, and phones.
• Ability to interact with others, both in person and through phone, e-mail, and written correspondence.
• Ability to lift up to 15 pounds.

Job Type: Full-time

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Experience:

• Insurance verification: 1 year (Required)
• Benefits administration: 1 year (Required)
• Customer service: 1 year (Required)

Language:

• Spanish (Required)

Work Location: In person

NEBA is a Third Party Administrator that supports the hardworking members of the Taft-Hartley community that are the backbone of our country. We perform administrative services to members regarding their health and retirement plans and encourage candidates to review our website for an overview of what we do.

Company Description

NEBA is a Third Party Administrator that supports the hardworking members of the Taft-Hartley community that are the backbone of our country. We perform administrative services to members regarding their health and retirement plans and encourage candidates to review our website for an overview of what we do.