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Benefits Administration Coordinator

Lucent Health Solutions, Inc.
Appleton, WI Full Time
POSTED ON 3/15/2025
AVAILABLE BEFORE 4/9/2025

About Lucent Health

Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers.

Company Culture

We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health.

Honest

  • Transparent Communication : be open and clear in all interactions without withholding crucial information
  • Integrity : ensure accuracy in reporting, work outputs and any tasks assigned
  • Truthfulness : provide honest feedback and report any issues or challenges as they arise
  • Trustworthiness : build and maintain trust by consistently demonstrating reliable behavior

Ethical

  • Fair Decision Making : ensure all actions and decisions respect company policies and values
  • Accountability : own up to mistakes and take responsibility for rectifying them
  • Respect : treat colleagues, clients and partners with fairness and dignity
  • Confidentiality : safeguard sensitive information and avoid conflicts of interest
  • Hardworking

  • Consistency : meet or exceed deadlines, maintaining high productivity levels
  • Proactiveness : take initiative to tackle challenges without waiting to be asked
  • Willingness : voluntarily offer to assist in additional projects or tasks when needed
  • Adaptability : work efficiently under pressure or in changing environments
  • Summary

    The primary focus of the Billing & Eligibility Coordinator as the Third Party Administrator is to administer COBRA, maintain dependent eligibility, determination and documentation of coordination of benefits (including Medicare eligibility), generate ID cards, on-line enrollment, maintain eligibility and enrollment for flexible spending, dependent day care, transportation, and health reimbursement accounts, prescription benefit manager updates / changes, updating rate information and communicating monthly invoices. Billing & Eligibility Coordinators are the primary contact for our clients, members, brokers, sales and claims administration in answering questions and resolving issues regarding eligibility and invoicing.

    Responsibilities :

  • Maintain enrollment and eligibility records for our clients in a timely and accurate manner.
  • Manage all facets of Billing & Eligibility for assigned clients.
  • Maintain group and member eligibility records efficiently and accurately.
  • Process COBRA paperwork / payments, flexible spending elections, dependent eligibility, coordination of benefits verification, certificates of creditable coverage, prescription benefit managers (RX) eligibility, on-line enrollment requests, and ID card requests.
  • Update / confirm eligibility updates received via electronic eligibility files.
  • Create and maintain enrollment, change, termination, flex, and other group forms.
  • Provide support to team members in achieving superior customer service and consistent turnaround times for all clients.
  • Communicate monthly invoice information to clients.
  • Provide responsive and professional customer service for both internal and external customers. Must possess both oral and written communication skills.
  • Maintain a positive and professional attitude.
  • Flexibility to work additional hours as dictated by needs of the department and business.
  • Report to work during core business hours (8 : 00 a.m. - 5 : 00 p.m.) on a consistent and regular basis.
  • Perform other duties as assigned by management.
  • Qualifications

  • 1-2 years previous Insurance experience in group eligibility and COBRA administration strongly desired.
  • Thorough understanding of Self-Funding Insurance and Third-Party Administrating concepts. Knowledge in Excel and Word.
  • Ability to navigate through and utilize 25 PC applications efficiently. Good phone etiquette.
  • Ability to proofread and audit documentation and reports. Demonstrated written and oral communication skills required.
  • Strong organizational skills, problem solving, and decision-making skills required.
  • Self-direction and self-starter skills required.
  • Must be able to work core business hours of 8 : 00 -5 : 00 in office.
  • Other Duties

    Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

    Physical and Emotional Demands :

    While performing the duties of this job, the employee is frequently required to sit. The employee is regularly required to stand; walk; use hands to finger, handle, or feel; reach with hands and arms; climb or balance; stoop, kneel, and talk or hear. The employee must occasionally lift and / or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, and ability to adjust focus.

    Equal Employment Opportunity Policy Statement

    Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.

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