Billing & Eligibility Coordinator

Responsibilities

• Review and reconcile client eligibility and payments.
• Determine active, retiree, and COBRA eligibility based on plan sponsor plan provisions.
• Process enrollment eligibility files and complete enrollment edits in system queues.
• Enter new employees and dependents into the system and make changes to existing records as required.
• Ensure identification cards are ordered correctly and timely according to plan sponsor and company guidelines.
• Post and reconcile client payments.
• Process vendor disbursements and reconcile payments according to vendor requirements and company guidelines.
• Disburse end‑of‑the‑month reports to clients as required.
• Complete the review of and respond to vendor discrepancy reports as assigned.
• Interpret and communicate COBRA and HIPAA regulations.
• Handle self‑pay administration according to plan provisions and guidelines.
• Answer email and call inquiries from participants, clients, vendors and local unions.
• Provide customer service and maintain effective relationships with clients, participants, agents, and brokers.
• Update and maintain Client Policy and Procedure documents.
• Adhere to and understand company eligibility policies, procedures and resources.
• Meet department production and quality metrics.
• Participate in mandatory department meetings, training, and company events.
• Complete company, department, or plan sponsor special projects.
• Follow company attendance policy and adhere to provisions in the collective bargaining agreement.
• Uphold and exemplify company values.
• Perform other duties as assigned.
• Review and process all internal and client‑specific weekly and/or monthly reports.
• Email and group folder organization.

• Completion of high school or equivalent, including or supplemented by coursework in bookkeeping, accounting, or a related field.
• AA degree preferred.
• Minimum 6 months of customer service experience, preferably with bookkeeping or accounting responsibilities.
• Must be able to operate a 10‑key adding machine.
• Must possess strong oral and written communication skills and strong basic mathematical skills.
• Proficiency in Microsoft applications and general computer literacy.

Demonstrates proficiency in client eligibility review, payment reconciliation, and adherence to COBRA and HIPAA regulations. Strong customer service skills are essential for maintaining effective relationships with clients and vendors.