Eligibility Specialist
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SIHO HOLDING INC
Columbus, IN, US
Summary
The Eligibility Specialist is responsible for managing enrollment, terminations, and eligibility updates for insurance customers. They also provide reporting, handle inquiries, and maintain accurate membership data in accordance with HIPAA guidelines.
Job Description
Job Details: Job Location: 435 Washington Street - Columbus, IN, Salary Range: Undisclosed, Job Category: Insurance, Job Title: Eligibility Specialist
Reports To: Manager, Eligibility
This is a non-exempt position with primary responsibility for handling enrollment and eligibility for SIHO customers. This position is also responsible for assisting employer contacts with needs pertaining to eligibility and providing reports and other information as needed.
Brief Description of Duties:
Respond to telephonic, written inquiries, and emails from accounts concerning eligibility issues.
Assist internal customers concerning eligibility issues.
Enroll, terminate, and change eligibility information as requested.
Initiate and handle student certification, tax dependent verification and disabled dependent verification.
Maintain eligibility audit reports.
Process enrollment of new groups as assigned.
Handle terminations of groups as assigned.
Track ID Card orders and re-order as needed.
Track eligibility issues and interactions in the membership system.
Prepare and communicate special reports as required by accounts.
Complete special projects (including research) as assigned by the supervisor.
Develop and maintain statistical data as required.
Create and mail letters of creditable coverage.
Represent the department when needed for internal and external company meetings.
Perform other Eligibility Department duties as assigned
Qualifications: Minimum Skills Requirement:
Expert level computer skills (Microsoft Excel and Word)
Ability to work with databases and software applications (e.g., HSP, HealthEx, etc.)
Highly collaborative with a positive mindset – highly functional in a team-based environment
Detail oriented - high accuracy rate and attention to detail
Demonstrated problem solving and analytical skills
Proven organization and time management skills
Excellent oral and written communications skills
Excellent customer service skills
General knowledge and understanding of health insurance
Ability to work at a self-directed pace in a changing, multi-task environment
Professional appearance and presence
Commitment to support and maintain confidentiality in accordance with HIPAA guidelines
Current PMAS performance evaluation of “3” or higher (for internal candidates)
All positions are subject to change based on the needs of the business
SIHO is a health insurance provider helping employers, brokers, and members navigate health benefits with confidence.
Since 1987, we’ve delivered personalized service, flexible benefit solutions, and trusted partnerships to the people and organizations we serve. We pair comprehensive health benefit capabilities with the accessibility, responsiveness, and human connection of a locally focused organization.
We work with businesses of all sizes, health systems, providers, and other partners to make health benefits easier to understand, easier to access, and more effective. By strengthening connections between members, providers, employers, and partners, we help create better experiences, improve health outcomes, and improve quality of life in the communities we serve.
Our comprehensive capabilities include:
-Fully insured, self-funded, and level-funded health plan solutions
-Third-party administration
-Provider network and health system development
-Population health management
-Wellness programs
-Flexible spending plan administration
-Integrated claims processing and customer service
-Dedicated support for employers, brokers, providers, and members
What sets SIHO apart is how we deliver these solutions. We listen first, respond thoughtfully, and remain flexible to the unique needs of those we serve. Our team combines sophisticated health benefit capabilities with personalized support and practical solutions, without losing sight of the people behind them.
Our mission is to connect quality care with innovative insurance solutions so members can truly thrive.
Service. Integrity. Health. Outcomes.
Founded
1987
Company size
51-200 employees
Industry
Insurance
Org type
Privately Held
Headquarters
Columbus, IN
SIHO is a health insurance provider helping employers, brokers, and members navigate health benefits with confidence.
Since 1987, we’ve delivered personalized service, flexible benefit solutions, and trusted partnerships to the people and organizations we serve. We pair comprehensive health benefit capabilities with the accessibility, responsiveness, and human connection of a locally focused organization.
We work with businesses of all sizes, health systems, providers, and other partners to make health benefits easier to understand, easier to access, and more effective. By strengthening connections between members, providers, employers, and partners, we help create better experiences, improve health outcomes, and improve quality of life in the communities we serve.
Our comprehensive capabilities include:
-Fully insured, self-funded, and level-funded health plan solutions
-Third-party administration
-Provider network and health system development
-Population health management
-Wellness programs
-Flexible spending plan administration
-Integrated claims processing and customer service
-Dedicated support for employers, brokers, providers, and members
What sets SIHO apart is how we deliver these solutions. We listen first, respond thoughtfully, and remain flexible to the unique needs of those we serve. Our team combines sophisticated health benefit capabilities with personalized support and practical solutions, without losing sight of the people behind them.
Our mission is to connect quality care with innovative insurance solutions so members can truly thrive.
Service. Integrity. Health. Outcomes.
Founded
1987
Company size
51-200 employees
Industry
Insurance
Org type
Privately Held
Headquarters
Columbus, IN