Billing & Eligibility Specialist

Billing & Eligibility Specialist – Hybrid – Nashville, TN

Location: Nashville, TN, USA

The Billing/Eligibility Specialist is a key part of the department’s successful operation. The specialist is in daily contact with members, clients, and providers, and therefore needs to be a cheerful, competent and compassionate representative of Lucent Health. The position is responsible for assessing, interpreting and processing incoming eligibility feeds through all possible correspondence venues. This includes, but is not limited to, Cobra requests, Eligibility File Audits, Individual paper eligibility forms and all other potential eligibility inquiries and forms.

Attendance can also directly impact the satisfaction level of our clients and the retention of our accounts.

• Administer and coordinate the day-to-day operations of the COBRA functions to ensure timely and accurate processing of group and individual COBRA updates.
• Manage COBRA enrollments, terminations, and premium payment updates through our internal systems.
• Respond to COBRA-related inquiries from former employees, beneficiaries, and insurance carriers.
• Stay current with COBRA regulations, ERISA, HIPAA and ACA compliance requirements.
• Coordinate with clients on plans that Lucent does not administer but does administer COBRA for, and update outside carriers accordingly with COBRA elections, terms, and changes.
• Generate COBRA reports weekly out of networking system.
• Perform all functions of the B&E role for assigned case load.

• 3–5 years of experience in benefits administration within a TPA or health plan environment; experience with self-funded plans with a focus on COBRA management.
• Strong understanding of COBRA, HIPAA, ERISA, and ACA regulations.
• Excellent analytical, organizational, and communication skills with strong attention to detail.
• Proficiency in benefit administration systems, data analysis tools, and Microsoft Office applications.

Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.