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Eligibility Representative

3 months ago


Warrendale, United States Careerbuilder-US Full time

Job Title: Eligibility Representative

Job Location: Warrendale, PA within a 50-mile radius. They must be able to come onsite if there are any issues with equipment, internet issues. (Remote but candidates must be local)

Job Duration: 6 months+ contract with possibility of extension. Might get converted full-time.

Shift Time: Training Schedule 8:30 am - 5 pm EST. Monday - Friday 8 am - 6:30 pm EST after Training - schedule will be based on need. Training Length: 4 weeks classroom training, 2 weeks on-the-job training.

Pay range: $19.50/hr. on W2

Job Summary

· 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, 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.