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Insurance Eligibility Specialist

2 months ago

Warrendale, Pennsylvania, United States Tailored Management Full time

Insurance Eligibility Specialist

Compensation: $19.50 per hour, with weekly payments

Work Environment: Fully remote, candidates must be located in the EST or CST time zones

Working Hours: Monday to Friday, during standard business hours

Contract Duration: 6 months, with the possibility of extension or conversion based on performance, attendance, and business requirements

Responsibilities:

  • Engage in inbound and outbound calls concerning insurance, prior authorizations, and copayment inquiries.
  • Manage call volumes effectively, with a flexible schedule post-training.
  • Participate in virtual training sessions, requiring proficiency with computers, telecommunication devices, and Microsoft applications.
  • Provide basic administrative services related to eligibility.
  • Establish and uphold eligibility for benefits, including updating and maintaining both automated and manual eligibility data.
  • Collaborate with internal teams and external clients/vendors to ensure accurate eligibility processing.
  • Generate reports to identify and rectify discrepancies, while seeking opportunities for process enhancements.
  • Negotiate and resolve eligibility issues with clients as necessary.
  • Offer technical assistance for electronic eligibility processing, ensuring timely and accurate customer data management.
  • Address technical issues by interacting with systems and clients.
  • Possess a general understanding of both manual and automated eligibility processes.
  • Familiarity with reporting tools is beneficial.
  • Demonstrate a solid understanding of business processes and operating procedures related to eligibility.
  • Work under clearly defined procedures with close supervision.

Qualifications:

  • Proficient with computers
  • Excellent phone-based customer service skills
  • Prior experience in customer service via phone is preferred but not mandatory
  • Job responsibilities will be conducted from home using a computer and phone
  • Ability to troubleshoot technical issues is preferred but not required

Education Requirements:

  • High School Diploma or equivalent