What are the responsibilities and job description for the Eligibility Specialist position at PromiseCare Management?
POSITION SUMMARY
The Eligibility Specialist analyzes, reviews, and oversees the eligibility lifecycle. Starting with loading all eligibility files to completing an analysis of members who have terminated. All eligibility updates/requests are expedited and must be handled within 24 hours. The ideal candidate is dependable, detail oriented, and has a strong work ethic.
The Eligibility Specialist is responsible for:
- Ensuring proper loading of all Health Plan eligibility and capitation files
- Updating the member’s eligibility as requested
- Redetermination review with applicable Health Plans
- Coordinate with the Health Plan on needed changes/updates
- Loading new benefits each year and as needed
- Analyzing member termination reports and identifying any trends
- Identifying and correcting member’s addresses from returned mail
- All other duties as assigned
SPECIFIC SKILLS NEEDED
- Strong attention to detail
- Proficient oral and written communication skills
- Able to multitask and work in a fast-paced environment
- Developing and maintaining Health Plan relationships
EDUCATION/EXPERIENCE/TRAINING
- Associates degree preferred
- Minimum of 1 year working in a managed care setting
- Proficiency with Microsoft Excel
- Experience working in capacity as eligibility coordinator or eligibility specialist
Job Type: Full-time
Pay: From $17.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Work Location: In person
Salary : $17