Maintains and processes eligibility and enrollments (new hires, terminations and changes) in Trizetto QicLink system on existing and new accounts to meet stated goals for quality and turn-around time.
1. Input eligibility data from enrollment forms and portal requests into TRIZETTO QicLink system meeting department accuracy standards.
2. Process enrollment adds and changes through the electronic file load process, also working any reports generated through that process.
3. Process terminations and other changes within the unique timelines established for specific accounts.
4. Review and determine eligibility and enrollment on assigned workload.
5. Request and process missing or additional information on questionable enrollments via telephone or in written form from clients/participants.
6. Determine appropriate eligibility for special enrollees and late entrants on new groups or renewal enrollments in accordance with plan documents.
7. Function as a back-up for other eligibility specialists as needed, completing tasks timely and accurately.
8. All other duties as assigned.