Enrollment & Eligibility Specialist Las Vegas, NV

Enrollment & Eligibility Specialist

Our client is seeking detail-oriented and empathetic Las Vegas-based Enrollment & Eligibility Specialists to join our team. In this role, you will provide telephonic support to members with benefits, eligibility, claims inquiry, claim reconsiderations and appeals.

Key responsibilities include:

• Handles frontline Culinary, Hospitality and/or Alaska volumes
• Provide timely and professional support to members and providers regarding benefits, eligibility, claims, and appeals
• Will be required to handle customer service inquiries via the contact center phones, email, and chat depending on business needs

Specific duties include:

• Handle escalated customer concerns and complaints
• Assist with Claims processing
• Collaborate with the Benefits Enrollment team to resolve eligibility, hours, and co-premium inquiries, proactively following up with members as needed
• Actively listen to customer concerns, demonstrating empathy and offering effective solutions
• Analyze and resolve non-standard and complex issues using critical thinking and problem-solving skills
• Maintain a strong understanding of client products, services, and policies to provide accurate and informed assistance
• Document all interactions and resolutions accurately in the system to ensure seamless customer service
• Adhere to regulatory requirements, company policies, and confidentiality guidelines when handling member information