Eligibility Specialist, PHIEA

About the position

The Eligibility Specialist at the Pennsylvania Health Insurance Exchange Authority (PHIEA) plays a crucial role in managing the day-to-day operations related to program eligibility. This position involves evaluating eligibility, conducting quality assurance checks, and addressing customer escalations and appeals. The specialist will work to resolve complex issues affecting health insurance access for Pennsylvanians, ensuring that individuals receive the necessary support under the Affordable Care Act.

Responsibilities
? Handle day-to-day operations of PHIEA's program eligibility.
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? Conduct evaluations and quality assurance checks related to eligibility.
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? Identify and resolve issues related to eligibility for health insurance programs.
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? Serve as the point of contact for customer escalations and appeals processes.

Requirements
? Four years of experience in reviewing and analyzing medical insurance policies and premiums.
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? Bachelor's degree in Business Administration, Healthcare Administration, or a related field, or an equivalent combination of experience and training.
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? Pennsylvania residency is required.
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? Ability to perform essential job functions.

Nice-to-haves
? Strong written and verbal communication skills.
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? Time management and presentation skills.
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? Experience with Affordable Care Act (ACA) federal or state-based exchanges.
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? Experience with health insurance companies.

Benefits
? Full-time telework opportunity with a securely configured high-speed internet connection.
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? Standard work hours from 8:00 AM to 4:30 PM, Monday to Friday.

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