Health Plan Enrollment Specialist II

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.

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* ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
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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.

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* ESSENTIAL FUNCTIONS
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• 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.

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  * OTHER FUNCTIONS
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• 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.

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* EDUCATION AND/OR EXPERIENCE
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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.

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* KNOWLEDGE, SKILLS, AND ABILITIES
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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,…