Insurance Eligibility Specialist

7 days ago


Scottsdale, Arizona, United States Community Medical Services Full time
Overview

Community Medical Services is seeking an Enrollment Specialist to complete verification of client eligibility on various Medicaid, Medicare, and Commercial Provider Portals. This role will maintain day-to-day enrollment and demographic processing in Community Medical Services Inc. EHR and EMR for all lines of business.

Responsibilities
  • Verify client eligibility on various provider portals
  • Respond to inquiries submitted to the Departmental Inbox
  • Maintain enrollment and demographic processing in EHR and EMR
  • Identify opportunities to improve process efficiency and accuracy
  • Perform audits and analyses on completed member data
  • Create, update, and submit demographics to applicable payers
  • Research and resolve rejected claims related to member data
Qualifications
  • High school diploma or equivalent
  • 3+ years of transaction processing, data reconciliation, membership records, or related managed care/healthcare experience
  • Experience in a managed care environment with provider information systems preferred
Benefits

As a valued member of our team, you can expect a comprehensive benefits package, including subsidized medical, dental, and vision insurance, health savings account, short and long-term disability insurance, life insurance, paid sick, vacation, and holiday time, 401K retirement plan with match, tuition and CME reimbursement up to 100%, employee assistance program, and ongoing professional development.



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