Eligibility EDI Analyst I

Get To Know Us!

WebTPA, a GuideWell Company, is a healthcare third-party benefit administrator with over 30+ years of experience building unique benefit solutions and managing customized health plans.

What is your impact?

The Eligibility EDI Analyst is responsible for working directly with the clients to assist with daily enrollment updates and inquiries, as they pertain to electronic data. This position will focus on maintaining operational procedures with high-level analytical thinking.

Position Details:

In office required at 6535 SH-161 S, Irving Texas 75039

What Will You Be Doing:

• Analyzes data and performs multiple routine audits and reconciliations to maintain benefit enrollment and eligibility data integrity, compliance and accuracy.
• Administers updates to enrollment for assigned client groups including changes, adds and terms.
• Proactively monitors data and troubleshoots errors to resolve issues impacting enrollment.
• Supports Open Enrollment testing, processing, and reporting as needed.
• Quickly and efficiently responds to client and internal questions and requests regarding eligibility and data.
• Generate eligibility reports and audits for assigned groups
• Resolves problems and escalates issues to management as appropriate.
• Actively participate and interact with customers to understand business needs, identify the best solution, and assist IT to architect the processes to meet the needs.

What You Must Have:

• 2+ years related work experience
• Related Bachelor's degree or additional related equivalent work experience
• Advanced knowledge and significant experience working with Microsoft Office; specifically, but not limited to Microsoft Word, Excel, and Access.
• Strong verbal and written communication skills
• Strong data analytics skills.
• Ability to prioritize or seek information on how to best prioritize projects.
• Project confidence, high energy, enthusiasm, and high regard for client advocacy and service.
• Ability to work independently/autonomously and proactively as well as collaboratively as a member of a team.
• Self-starter with the ability to identify problems/issues and offer workable solutions.

What We Prefer:

• Experience in the health insurance administration industry a plus.

What We Can Offer YOU!

To support your wellbeing, comprehensive benefits are offered. As a WebTPA employee, you will have access to:

• Medical, dental, vision, life and global travel health insurance
• Life insurance, Short- and long-term disability programs
• Leave programs to support personal circumstances.
• 401(k) includes employer contribution match
• Paid time off, volunteer time off, and 11 holidays
• Additional voluntary benefits options avaliable
• Comprehensive wellness program

Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for interns and part-time employees may differ.

General Physical Demands

Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally.

We are an Equal Employment Opportunity employer committed to cultivating a work experience where everyone feels like they belong and can perform at their best in pursuit of our mission. All qualified applicants will receive consideration for employment.