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Eligibility Specialist Jobs

Eligibility Analyst Jobs
By North Highland At Columbia, SC, United States
Experience using a Medicaid Eligibility System(s);
Experience reviewing/analyzing applications in a high volume/high productivity environment;
High attention to detail including precise and effective customer communications and proven ability to manage multiple, competing priorities simultaneously;
Analyst with an understanding of Medicaid Eligibility Rules;
Eligibility Specialist Jobs
By Ascendo Resources At Tampa, FL, United States
Conduct client interviews and collect detailed information on their business and experience
Research governmental mandates and information to supplement ERC eligibility on a case-by-case basis
Research specific orders that caused disruption to client’s business operations
Analyze and interpret data gathered to guide decision making
Create reports to summarize research findings and the implications of the results
Perform compliance reviews to ensure accuracy and completeness
Eligibility Analyst (Remote) Jobs
By Prime Therapeutics At Minneapolis, MN, United States
Strong organizational and time management skills
2 years experience in healthcare, PBM, Eligibility or claims processing
Strong oral and written communication skills
Problem solving skills with strong attention to detail
Experience working in eligibility or enrollment
Reports to a Supervisor or Manager in the PBM Operations department
Eligibility Specialist Jobs
By ReviveHealth At United States
Ability to multi-task using multiple computer systems with strong organizational and time management skills
Performs other responsibilities as assigned
One year of enrollment data or other related work experience
Beginner Excel experience required, Intermediate preferred
Demonstrated attention to detail and analytical skills relating to reconciling and problem-solving using data
Previous experience working with health insurance or in a health care environment preferred
Eligibility Specialist Ii (Sr-Non-Magi) / 60017385
By State of South Carolina At Horry County, SC, United States
Health, Dental, Vision, Long Term Disability, and Life Insurance for Employee, Spouse, and Children.
15 days annual (vacation) leave per year.
15 days sick leave per year.
State Retirement Plan and Deferred Compensation Programs.
Overtime and/or weekend work with Deputy approval.
Sitting or standing for long periods of time.
Eligibility Specialist Ii (Ltcw) / 61100336Tg
By State of South Carolina At Columbia, SC, United States
Health, Dental, Vision, Long Term Disability, and Life Insurance for Employee, Spouse, and Children.
15 days annual (vacation) leave per year.
15 days sick leave per year.
State Retirement Plan and Deferred Compensation Programs.
Overtime and/or weekend work with Deputy approval.
Sitting or standing for long periods of time.
Eligibility Specialist Ii (Non-Magi) / 61062018
By State of South Carolina At Lexington County, SC, United States
Health, Dental, Vision, Long Term Disability, and Life Insurance for Employee, Spouse, and Children.
15 days annual (vacation) leave per year.
15 days sick leave per year.
State Retirement Plan and Deferred Compensation Programs.
Overtime and/or weekend work with Deputy approval.
Sitting or standing for long periods of time.
Healthcare Eligibility Analyst Jobs
By Akkodis At United States
•Experience in a call center role is preferred, or demonstrating application of similar skills.
Job Title: Healthcare Eligibility Analyst
Pay Rate: $14-16/hr. on W2
•High School diploma or GED is required
•Must submit to and pass a 10-panel drug screen pre-employment (and throughout employment if required).
If you are available for this Amazing opportunity please share your updated resume.
Insurance Eligibility Specialist Ii
By Brightside Health At United States
Have good organizational, multi-tasking, and time management skills, with excellent attention to detail.
Have advanced Excel skills, with the demonstrated ability to write formulas, perform VLOOKUP, pivot tables, etc.
Have knowledge of EDI 270/271 transactions and insurance eligibility verification Have strong work ethic, resourcefulness, and the motivation to succeed
Have experience working with insurance companies in the healthcare provider industry
3-5 years previous experience in medical billing, current A/R & experience in patient services a plus.
Maintain knowledge of industry standards for insurance verification Understand and adhere to HIPAA policies, procedures, and regulations, maintaining strict confidentiality
Eligibility Specialist Jobs
By Texas Children's Hospital At Greater Houston, United States
2 years previous experience working at or with an HMO or MCO organization required
A bachelor’s degree may substitute for the years of required work experience
Being fully vaccinated against COVID-19 is required for all employees unless approved for a medical or religious exemption
High school diploma or GED required
Manually update member eligibility data in the claims processing system using multiple sources for reference, including applications, databases, and reports
Research and resolve member eligibility issues thoroughly, timely, and accurately
Data Analyst (Eligibility) Jobs
By Performant Corp At United States
Assist technical and business leads with requirements gathering, documentation, and project management for new implementations and existing program changes.
Knowledge and experience with Healthcare, Coordination of Benefits, Third Party Liability, and/or Medicare Secondary Payer
Correct areas of deficiency and oversight received from quality reviews and/or management.
Knowledge of requirements gathering, ETL processing and data matching
Bachelor’s degree in relevant field or equivalent combination of education and experience.
Leverage knowledge and expertise in COB/TPL/MSP to review eligibility and client data.
Eligibility Specialist Jobs
By NYC HRA/DEPT OF SOCIAL SERVICES At , Manhattan, 10048, Ny $40,062 - $59,390 a year
Provide information about transitional benefits to encourage financial independence through employment.
Maintain a caseload by managing time effectively including Face-to Face recertification interviews, participants’ appointment schedules, processing paperwork, training and meetings.
Complete agency forms to facilitate the appropriate issuance of benefits and participants notification.
Benefits Access Center (BAC) East End; 2322 Third Avenue, New York, NY 10035
Identify and provide special and or emergency needs in a timely manner.
Accurately complete Fair Hearing/Aid to Continue compliance and resolutions within prescribed deadlines.
Eye Care Program Eligibility Specialist
By Lumata Health At Oklahoma City, OK, United States
Experience in a phone-based reception environment, preferred.
Outstanding communication skills, both written and verbal.
Ability to work remotely with reliable Wifi access.
Collecting and analyzing patient information for determining eligibility for an eye care support program.
Determining initial and ongoing eligibility for the eye care program in accordance with established procedures.
Maintaining accurate records of patient eligibility activities, as well as departmental operations in compliance with HIPAA and other regulatory guidelines.
Eligibility Specialist – Lead Worker - Family Team
By Scott County, MN At , Shakopee, Mn $62,056 - $73,007 a year
High school diploma/GED plus one or more years post-secondary education and three years of related work experience**
high school diploma/GED plus one or more years post-secondary education and three years of related work experience**
High school diploma/GED and five years of related work experience** OR
For detailed benefit information visit the Scott County Benefit Hub at
Health Insurance - Four-tier plan option available
Dental Insurance - Four-tier plan option available
Integrated Services Specialist - Eligibility, Billing And Recon
By CVS Health At , Hartford, Ct $17.00 - $27.90 an hour
General knowledge and understanding of Marketplace Insurance, or exchange business.
Experience with problem solving and process improvement initiatives.
Background in Enrollment and Eligibility and/or Accounts Receivable.
Excellent verbal and written communication.
High data integrity and accuracy within processes.
Ability to work in a fast paced and deadline driven environment.
Eligibility Specialist/Assistance Payments Worker
By State of Michigan At , Saint Joseph, 49085, Mi Up to $200,000 a year
Alternative and Remote Work Schedules:
Ensuring that each person/family that applies for public assistance receives the type and level of assistance that they are eligible for
Providing all families with information about the expectations and goals of the Michigan Department of Health and Human Services (MDHHS).
Encouraging and guiding families in their efforts to become self supporting
Failure to complete any of the above items may result in your application being screened out.
A secure work location that allows privacy and prevents distractions.
Eligibility Specialist Ii (Non-Magi) / 61061959
By State of South Carolina At Charleston, SC, United States
Health, Dental, Vision, Long Term Disability, and Life Insurance for Employee, Spouse, and Children.
15 days annual (vacation) leave per year.
15 days sick leave per year.
State Retirement Plan and Deferred Compensation Programs.
Overtime and/or weekend work with Deputy approval.
Sitting or standing for long periods of time.
Unit Eligibility Specialist Jobs
By Washington County, OR At , Hillsboro, 97124, Or $4,486 - $5,451 a month
Three (3) years of work experience in building inspection, property management, building maintenance, or residential construction.
Accommodation under the Americans with Disabilities Act
Part-time regular, variable hour, and temporary positions are not eligible for medical, dental, and vision benefits.
Check Out Our Award-Winning Benefits & Wellness Program!
Possession of a high school diploma or equivalent; AND
Must possess a driver's license valid in the State of Oregon and have an acceptable driving record.
Eligibility Specialist Jobs
By INNOVATIVE INTEGRATED HEALTH INC At , Bakersfield, Ca $20 - $25 an hour
Proficient knowledge of computer skills, including Microsoft Office (Word, PowerPoint, and Outlook)
Minimum of two (2) years of professional experience in managed care organizations, required without an Associate’s Degree
Knowledge of general office procedures, equipment, and filing systems
Experience in the health care field, preferred
Associate’s Degree, required without professional experience
Track eligibility/enrollment changes daily for documentation purposes
Eligibility Consultant (100% Remote) Jobs
By CVS Health At , , Sc $17.00 - $27.90 an hour
Applies all appropriate considerations associated with technical requirements, legislative/regulatory policies, account structure and benefit parameters in addressing eligibility matters. (*)
Completes data entry requirements for finalizing new enrollment information as well as for changes and/or
Interprets and translates client benefits and supporting account structure against internal systems/applications(i.e.,GEBAR, AAS, and CCI). (*)
Strong verbal and written communication skills.
Knowledge of Health Care and/or MCO’s.
Knowledge and comfortability with learning different systems and using Excel

Are you looking for a rewarding career that makes a difference in people's lives? Join our team as an Eligibility Specialist and help us ensure that those in need receive the benefits they deserve!

Overview:

An Eligibility Specialist is responsible for determining the eligibility of applicants for various programs and services. They must be knowledgeable of the laws, regulations, and policies that govern the programs they are responsible for. They must also be able to interpret and apply these laws and regulations to determine eligibility.

Detailed Job Description:

An Eligibility Specialist is responsible for determining the eligibility of applicants for various programs and services. This includes assessing the applicant’s financial, medical, and other eligibility criteria. They must be knowledgeable of the laws, regulations, and policies that govern the programs they are responsible for. They must also be able to interpret and apply these laws and regulations to determine eligibility. Eligibility Specialists must also be able to communicate effectively with applicants and other stakeholders. They must be able to explain the eligibility criteria and the process for applying for the program.

What is Eligibility Specialist Job Skills Required?

• Knowledge of laws, regulations, and policies related to eligibility
• Ability to interpret and apply laws and regulations
• Ability to communicate effectively with applicants and other stakeholders
• Ability to explain eligibility criteria and the application process
• Ability to maintain accurate records
• Ability to work independently and as part of a team
• Ability to work with a variety of computer programs

What is Eligibility Specialist Job Qualifications?

• Bachelor’s degree in social work, public administration, or a related field
• Experience in a customer service or administrative role
• Knowledge of eligibility criteria for various programs
• Knowledge of computer programs such as Microsoft Office

What is Eligibility Specialist Job Knowledge?

• Knowledge of laws, regulations, and policies related to eligibility
• Knowledge of eligibility criteria for various programs
• Knowledge of computer programs such as Microsoft Office

What is Eligibility Specialist Job Experience?

• Previous experience in a customer service or administrative role
• Previous experience in a social work or public administration role

What is Eligibility Specialist Job Responsibilities?

• Assess applicants’ financial, medical, and other eligibility criteria
• Interpret and apply laws and regulations to determine eligibility
• Communicate effectively with applicants and other stakeholders
• Explain eligibility criteria and the application process
• Maintain accurate records
• Work independently and as part of a team
• Work with a variety of computer programs