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Eligibility Coordinator

2 months ago

Long Beach, United States Advanced Medical Manage Full time
Job DescriptionJob Description

POSITION SUMMARY

The Eligibility Coordinator is responsible for maintaining member data in EZ-CAP. Ensures that all eligibility data is current and accurate. Responsible for resolving eligibility inquiries and communicating outcomes to other departments within AMM.

RESPONSIBILITIES-DUTIES

  • Responsible for verifying members eligibility including coordination of benefits.
  • Responsible for manually entering new members in EZCAP after verifying eligibility though health plan portals or contacting the health plan by phone.
  • Responsible for making appropriate changes in EZ-CAP regarding member demographics, PCP or benefit assignments, eligibility dates and terminations.
  • Responsible for responding to emails requesting eligibility verification.
  • Responsible for printing monthly welcome letters for new members.
  • Responsible for printing monthly birthday letters for members.
  • Assist with various eligibility reports to eliminate duplicate members, correct/update incorrect addresses, verify eligibility for members that fall off the monthly eligibility files.
  • Maintain an average of 75-member eligibility verifications daily and be concise in all work.
  • Introduction to Onbase average 50-member eligibility verifications on a daily basis.
  • Assist with any other tasks that may be assigned by Supervisor/Manager.

EDUCATION & EXPERIENCE REQUIREMENTS

  • Excellent communication skills
  • Attention to detail
  • Great customer service skills
  • Organizational skills
  • Problem solving
  • Data entry
  • Team oriented
  • Knowledge of Microsoft Office
  • Computer literate with keyboard skills
  • Ability to function in a fast-paced environment
  • Must have a high school diploma or equivalency
  • One (1) year experience in the medical field with knowledge of health plan eligibility verification processes
  • Knowledge of EZ-Cap preferred.