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Benefit Eligibility Specialist Jobs

Head Administrative Clerk/Veterans Benefit Specialist
By City of Boston At Boston, MA, United States
Interviews applicants for veterans’ benefits making thorough investigations as to the legality and need for relief.
Performs extensive research of applicants including address (es), employment status, service dates, discharge types, dependent information, and related information.
Engages in the determination of eligibility and need of veterans and their dependents under M.G.L Chapter 115, as amended.
May conduct home visits and/or field investigations.
Coordinates the communication between caseworkers and veterans.
Keeps records on action taken on cases and submits monthly reports on all active cases.
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
Benefit Verification Specialist Jobs
By Lash Group At United States
MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS:
Reports any reimbursement trends/delays to management.
An equivalent combination of education and experience will be considered.
Proficient Windows-based experience including fundamentals of data entry/typing.
Reviews all patient insurance information needed to complete the benefit verification process.
Verifies patient specific benefits and precisely documents specifics for various payer plans including patient coverage, cost share, and access/provider options.
Pharmacy Benefit Specialist Jobs
By VanderHouwen At United States
Perform data entry into the claims processing system, document management systems, databases, and spreadsheets as assigned.
Knowledge, Skills, and Abilities Required:
Ability to learn new skills and abilities.
Pharmacy Benefits Specialist I Responsibilities
Pharmacy Benefits Specialist I Qualification:
Educate members, providers, pharmacies, and staff about the formularies and pharmacy benefit policies.
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.
Benefit Specialist - Remote
By Imagine360 At United States
2+ years' experience in client services, account management, or similar customer service related field
Manage assigned member caseload via high-touch advocacy model with a focus on elevating the member experience and promoting engagement.
Experience in healthcare and/or employee benefits
Understand product and program guidelines and working to educate CRMs and customers on the capabilities of and best practices for client.
Serve as the liaison to the support organization for client knowledge, and for appropriately managing escalations.
Imagine360 is currently seeking a Benefit Specialist to join the team!
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
Claim Benefit Specialist Jobs
By CVS Health At , Tampa, Fl $17.00 - $27.90 an hour

Analyzes and approves routine claims that cannot be auto adjudicated. Applies medical necessity guidelines, determine coverage, complete eligibility verification, identify discrepancies, and applies ...

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.
Claim Benefit Specialist Ops
By CVS Health At , , Sc $17.00 - $27.90 an hour
Identify claim cost management opportunities and refer claims for follow up
Determine and understand the coverage provided under a member's health plan
Efficiently use multiple systems and screens to obtain and record claim information
Review claims information to determine the nature of a member's illness or injury
Process claims accurately to enhance customer satisfaction and retention
Process claims within quality and production standards
Claim Benefit Specialist Jobs
By CVS Health At , , Pa $17.00 - $27.90 an hour
Routes and triages complex claims to Senior Claim Benefits Specialist.
Proofs claim or referral submission to determine, review or apply appropriate guidelines, coding, member identification process, diagnosis and pre-coding requirements.
Experience in a production environment.
Reviews and adjudicates routine claims in accordance with claim processing guidelines.
Analyzes and approves routine claims that cannot be auto adjudicated.
Coordinates responses for routine phone inquiries and written correspondence related to claim processing issues.
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.
Benefit Program Specialist Jobs
By State of Missouri At , Poplar Bluff, 63901, Mo $40,935 a year
Manage a caseload of approximately 450-550 children;
Knowledge of the techniques of financial investigation, research, and resource identification.
Knowledge of principles and techniques interviewing, and negotiation.
Ability to interpret, explain, and apply policies, rules, regulations, procedures, and requirements, pertaining to the assigned program(s).
Division or Finance and Administrative Services (DFAS)
Monitor the child’s KIDS account and/or Dedicated KIDS accounts to ensure adequate eligibility limits for both SSI and Title IV-E;
Cost-Benefit Analysis Specialist Jobs
By FAO At , Remote
Qualified female applicants, qualified nationals of non-and under-represented Members and person with disabilities are encouraged to apply
Develop data gathering instruments or survey forms necessary to collect information required to conduct a cost-benefit analysis on the EPAHP program;
Working knowledge (Level C) of English
Knowledge Sharing and Continuous Improvement
The Cost-Benefit Analysis Specialist directly reports to the Assistant FAO Representative (Programme) and MIS Specialist
The Cost Benefit Analysis Specialist will carry out the following tasks:
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.