Eligibility specialist

Randstad is currently seeking a detail-oriented Eligibility Specialist for a contract-to-hire opportunity with a leading national dental insurance provider.

In this role, you will serve as a key operational anchor responsible for processing, verifying, and maintaining member dental coverage and enrollment data. You will ensure that member eligibility records are processed accurately within established SLAs while handling data updates, resolving discrepancies, and supporting internal teams to deliver seamless service to policyholders and providers.

Qualifications:

• 1-3+ years of experience in eligibility determination, enrollment processing, or benefits administration within the healthcare or dental insurance industry
• Familiarity with dental benefits structures, insurance terminology, and medical/dental policy standards
• Experience navigating health management database systems, Microsoft Excel (basic formulas, data filtering, lookup functions), and electronic data interface formats
• High accuracy rate in data entry and complex information management under tight deadlines
• Written and verbal communication skills for cross-departmental coordination and issue reporting

Contact Angela Thompson at View phone number on click.appcast.io or View email address on click.appcast.io for more information


salary: $19 - $19.5 per hour
shift: First
work hours: 9 AM - 6 PM
education: High School

Responsibilities

• Review, verify, and input member eligibility data, plan selections, and qualifying life event updates into internal administrative management systems.
• Research and resolve complex coverage discrepancies, system errors, and data transmission issues (e.g., electronic data interchange/834 files).
• Partner with Customer Service, Claims, and Billing teams to clarify benefit status and ensure timely claim processing.
• Maintain strict adherence to HIPAA guidelines, federal/state regulations, and company policy regarding data privacy and security.
• Maintain accurate group rosters, process terminations, reinstatements, and Cobra/continuation-of-coverage update

Skills

• Healthcare
• HIPAA
• Health Insurance Policies (1 year of experience is required)
• Enrollment Processing (1 year of experience is required)
• Benefits Administration
• Insurance terminology
• Microsoft Excel (2 years of experience is required)
• CRM
• Data Entry
• Claims Processing
• EHR/Epic

Qualifications

• Years of experience: 2 years
• Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.


Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact View email address on click.appcast.io.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.