Especialista en consultoría - Coahuila - Remote Team Solutions

Descripción

Job Title: Client Services & Eligibility Specialist

Job Overview

We are looking for a Client Services & Eligibility Specialist to manage and ensure the accuracy of employee eligibility data for health benefits. In this role, you will work with brokers, employers, and third-party administrators (TPAs) to validate and process eligibility information, ensuring seamless access to services. This is a remote position with a focus on operational excellence and precision in handling sensitive data.

Key Responsibilities

Eligibility Management (Primary Focus)

• Manage day-to-day eligibility operations for brokers, employers, and TPAs.
• Process member adds, terms, and updates via spreadsheets, file transmissions, and system entries.
• Review and validate eligibility files for accuracy, completeness, and formatting requirements.
• Monitor file transmissions, investigate anomalies, and resolve data errors.
• Research and correct eligibility discrepancies, coordinating with clients and partners.
• Ensure all eligibility changes are processed accurately and in a timely manner to support seamless member activation and benefit access.

Client Communication & Support

• Serve as a primary point of contact for client eligibility questions-via email, chat, phone, and video.
• Provide clear guidance to clients on eligibility processes, file formats, timelines, and requirements.
• Document trends, recurring issues, and potential solutions to improve the client experience.

Onboarding & Data Coordination

• Assist with onboarding new clients by collecting and managing eligibility-related data.
• Confirm required file specifications, eligibility layouts, and transmission processes.
• Collaborate with internal teams to ensure onboarding data is accurate and ready for launch.

Continuous Improvement & Collaboration

• Identify process barriers or gaps in eligibility workflows, recommending enhancements.
• Work cross-functionally to align service delivery, file processing, and technical operations with client needs.
• Maintain a strong working knowledge of products, benefits, and systems to support accurate eligibility handling.

Qualifications

• Proven experience in eligibility management, client services, customer success, benefits administration, or a related operational role.
• Strong attention to detail with the ability to identify and resolve data inconsistencies.
• Excellent written and verbal communication skills, including the ability to explain technical and data-related information clearly.
• Proficiency with spreadsheets, eligibility file formats, remote communication tools (Zoom, Slack), CRM platforms, and digital support systems.
• Strong organizational and time management skills, with the ability to manage multiple clients and file timelines.
• Problem-solving mindset with a focus on delivering accurate, timely solutions.
• Ability to work independently while collaborating effectively with a small, agile team.
• Adaptable, flexible, and comfortable stepping into various responsibilities within a dynamic environment.

What We Offer

• Competitive Salary
• Opportunities for Career Development
• Collaborative Team Culture
• Employee Benefits