Job#: 3053699 Job Description: Location: Akron Ohio, Fully Onsite Monday - Friday
3 Month Contract
$17-19/HR
This role is responsible for managing and maintaining member eligibility, enrollment, premium billing, and claims-related transactions within healthcare systems while ensuring compliance with federal, state, and regulatory requirements. The position serves as a critical link between members, providers, employer groups, brokers, and internal operational teams to ensure accurate enrollment records, billing information, and healthcare coverage data.
Core ResponsibilitiesEligibility & Enrollment Administration- Process, implement, and maintain member and group enrollment records in healthcare claims and eligibility systems.
- Ensure timely and accurate setup of new members, employer groups, and coverage updates.
- Review enrollment files, validate data accuracy, and resolve system-generated errors.
- Reconcile enrollment and billing data between internal systems and third-party vendors.
Compliance & Regulatory Oversight- Maintain knowledge of healthcare regulations impacting enrollment, eligibility, and premium billing.
- Investigate and resolve transactions rejected by CMS, Health Insurance Marketplace systems, and other regulatory entities.
- Monitor operational processes for compliance risks and take corrective action when deficiencies are identified.
- Assist in developing and maintaining policies, procedures, and workflows that support regulatory compliance.
Data Analysis & Quality Assurance- Analyze enrollment, eligibility, and billing data to identify inconsistencies, trends, and operational issues.
- Conduct audits and quality reviews of files exchanged with external vendors and partners.
- Research discrepancies and recommend solutions to improve accuracy and efficiency.
- Perform data reconciliation activities to ensure system integrity and compliance.
Customer Service & Stakeholder Support- Provide support to members, providers, employers, brokers, and internal teams regarding:
- Eligibility and enrollment status
- Premium billing inquiries
- Coordination of benefits
- Primary care provider assignments
- Address and demographic updates
- Respond to inquiries received through phone, email, portals, and workflow management systems.
- Document client interactions and ensure requests are routed to the appropriate departments for resolution.
Operational Support- Manage inbound support requests and maintain accurate records within document management systems.
- Process, organize, and batch correspondence for electronic storage.
- Work independently on assigned tasks while collaborating with cross-functional teams to meet departmental objectives.
- Support continuous improvement initiatives focused on operational accuracy and customer satisfaction.
Key QualificationsExperience- 1+ year of experience in one or more of the following:
- Healthcare enrollment or eligibility processing
- Claims administration
- Healthcare operations support
- Data auditing and reconciliation
- Customer service within a healthcare environment
Technical Skills- Basic proficiency with Microsoft Excel, Word, and Access.
- Experience working with claims, enrollment, eligibility, billing, or healthcare administration systems.
- Ability to type at least 35 WPM with high accuracy.
Critical Competencies- Strong analytical and problem-solving abilities.
- Exceptional attention to detail and proofreading skills.
- Ability to interpret data and make informed recommendations.
- Strong organizational and time-management skills.
- Excellent verbal and written communication skills, including interaction with leadership.
- Ability to handle confidential health and business information.
- Sound judgment and the ability to work independently in a fast-paced, changing environment.
EEO Employer
Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Employee Services Department at or .
Everforth Apex is a world-class IT services company that serves thousands of clients across the globe. When you join Everforth Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRateds Best of Staffing in Talent Satisfaction in the United States and Great Place to Work in the United Kingdom and Mexico.
Everforth Apex uses a virtual recruiter as part of the application process. Click for more details. By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from Everforth Apex and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy at
Everforth Apex Benefits Overview: Everforth Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection. We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure. Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts. In terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Everforth Apex has a dedicated customer service team for our Consultants that can address questions around benefits and other resources, as well as a certified Career Coach. You can access a full list of our benefits, programs, support teams and resources within our 'Welcome Packet' as well, which an Everforth Apex team member can provide.
Everforth Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Everforth Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law.
If you require an accommodation under the Americans with Disabilities Act to participate in an interview with a virtual recruiter or to use our website for a search or application, please contact our Benefits Department at or . Please note that this contact information is strictly to be used for medical ADA accommodations and that no other inquiries will be answered.
UnitedHealthcare creates and publishes the Transparency in Coverage Machine-Readable Files on behalf of Everforth Apex Systems.
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