Eligibility Representative

4 weeks ago

Warrendale, United States Pyramid Consulting, Inc Full time

Immediate need for a talented Eligibility Representative. This is a 03+ Months Contract opportunity with long-term potential and is located in Warrendale, PA (Onsite). Please review the job description below and contact me ASAP if you are interested.


Job ID:24-37870


Pay Range: $19.50/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:


  • With this job you will make and take phone calls regarding insurance, prior auth, and copay issues.
  • You will be making and taking calls in this role.
  • Your schedule after training may or may not differ depending on call volume.
  • Training will be conducted virtually so all candidates should be experienced with computers, phones, and Microsoft software, etc.
  • Delivers straightforward administrative and/or other basic business services in Eligibility. Implements and maintains eligibility for benefits. Implements, updates, and maintains automated, direct connect and/or manual eligibility data. Interacts with internal partners and/or external clients/vendors.
  • Generates reports to identify and resolve discrepancies. Identifies process improvement opportunities for own cases.
  • May negotiate and resolve eligibility with clients.
  • May provide technical support for the electronic processing of eligibility.
  • Ensures customer data is installed accurately and timely.
  • May work with client's format and internal Systems to resolve errors.
  • May interact with Systems to resolve technical issues. General knowledge of manual and automated eligibility. Familiar with reporting tools.
  • Technical understanding of systems. Issues tend to be routine in nature.
  • Good knowledge and understanding of Eligibility and business/operating processes and procedures. Works to clearly defined procedures under close supervision.


Key Requirements and Technology Experience:


  • Key Skills-Call Center ; Insurance Verification; Healthcare Insurance.
  • Computer Savvy
  • Great Phone Customer Service
  • Must work M-F with limited call outs.
  • This role is for our busy season 1:1 and our FTE employees are blocked from taking PTO and I will set the same standard for the contracted workers.
  • Customer Service phone experience preferred not required
  • Job functions will be performed at home using a computer and phone
  • Able to trouble shoot tech issues is preferred not required as all work is done on a computer.
  • High School Diploma
  • Completed High School (Diploma or GED)
  • Training Schedule 8:30am - 5pm EST
  • Monday - Friday 8am - 6:30pm EST after Training - schedule will be based on need
  • Training Length: 4 weeks classroom training, 2 weeks on the job training
  • Notes: Candidates must be reliable, with reliable internet. Must have the ability and experience to WAH. Must know how to set up equipment and navigate a computer.


Our client is a leading Healthcare Insurance Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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