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Eligibility Specialist

1 month ago

Sandton, South Africa HR Studio Full time
Job Title: Eligibility Specialist

We're seeking a highly skilled Eligibility Specialist to join our team at HR Studio. As an Eligibility Specialist, you will play a critical role in ensuring the smooth processing of benefit entries and validating information.

Key Responsibilities:
  • Manage eligibility additions and terminations, ensuring compliance with legal requirements and client specifications.
  • Process changes for new and renewing clients using electronic files, paper forms, and portals.
  • Verify that enrollments are activated promptly and that information is accurately and fully entered.
  • Collaborate with providers, vendors, and internal departments to resolve billing or technical issues related to eligibility.
  • Assist the team in reviewing system configurations and processes to ensure optimal processing.
  • Audit and validate ID card processing, and generate and mail required notices for all product lines.
Requirements:
  • Matric or Diploma or equivalent.
  • 2 years of experience in eligibility, enrollment, or benefits customer service role focused on eligibility.
  • Strong knowledge of health insurance plans and employee benefits.
  • Familiarity with benefit administration platforms such as Javelina.
  • Proficient in standard computer applications, including MS Word, Excel, Outlook, and PowerPoint.
Working Hours:

2pm - 11pm