Eligibility Specialist Jobs

About us

https://revive.health

ReviveHealth provides individuals with easy and timely access to quality physical and mental health care, a personal collaborative care team, and prescription drugs at no cost.

ReviveHealth is pioneering in a new era of Health Assurance with affordable solutions for healthcare. By leveraging innovative technologies to create a virtual, data driven consumer platform that promotes a simplified best in class consumer experience, ReviveHealth is focused on healthcare and well-being that is simple, affordable, and accessible.

Responsibilities:

· Reviews daily member eligibility rejection files, identifies discrepancies and troubleshoots issues with enrollment data received in various formats; EDI (Electronic Data Interchange) transactions, CSV, and Excel spreadsheets

• Proactively troubleshoots to ensure accuracy of eligibility information and provides solutions to file issues; assists with determining extent and reason for discrepancies
• Researches and responds to eligibility file issues identified across the enterprise; works with the internal team to fix transactions that could not be processed via electronic file
• Performs other responsibilities as assigned
• Reviews, reconciles, and analyzes enrollment and eligibility reports and compares data to validate eligibility in our system
• Documents work performed to provide visibility to multiple departments
• Develops subject matter expertise on multiple file processing systems, file structures, and processes
• Interacts / communicates effectively with various departments
• Monitors, reports, and tracks error trends to identify resolution initiatives
• Assists with QA testing of eligibility related software development

Qualifications:

• Ability to effectively present information in a clear and concise manner
• Ability to analyze and interpret verbal and written instructions
• EST or CST preferred
• Previous experience working with health insurance or in a health care environment preferred
• Beginner Excel experience required, Intermediate preferred
• One year of enrollment data or other related work experience
• High School Degree required
• Working knowledge of Microsoft Office
• Ability to multi-task using multiple computer systems with strong organizational and time management skills
• Demonstrated attention to detail and analytical skills relating to reconciling and problem-solving using data
• Demonstrated strong commitment to a high level of customer service

ReviveHealth provided the following inclusive hiring information:

We are an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.