Eligibility Coordinator

Job TitlePRINCIPLE RESPONSIBILITIES include but are not limited to:Coordinates the input of member eligibility for all new groupsAssists with the implementation process for new clientsCoordinates with client contacts to ensure information is received is accurate and timelyEnrolls on-line management (Portal) users and maintains accountsEnrolls new members and/or processes terminationsWorks with multiple departments to coordinate eligibility requirementsUtilizes both manual and systematic enrollment processReviews daily reporting for eligibility correctionsAnswers incoming telephone calls related to eligibility needsEnsures eligibility systems are updated and data is appropriately integrated on a daily basisMaintains the eligibility files for medical coverage recipients (PHI)Handles escalated eligibility issues to ensure problems are resolvedEnsures that all correspondence and eligibility files are properly maintainedPerform scheduled review and quality assurance for member eligibilityAssist with go-lives and testing data filesPerforms various related duties as assigned including but not limited member communications, personal importation, overflow IC phone support, pharmacy network tasks; etc.SKILLS AND REQUIREMENTS:High school diploma or equivalent required.Post high school or specialized training in medical field desired.Minimum three years experience in a customer service position, preferably as an Office Manager or a similar service position in the health care industry.Must have excellent communication skills and the ability to work effectively with clients, pharmacies, and plan members, internal and external contacts.Proficient PC skills in Windows-based applications.Health insurance background and knowledge of pharmacy terminology desired.Ability to be flexible and quickly adapt to changing needs in department.Must be highly organized with strong attention to detail.Must be flexible with scheduled work hours.PHYSICAL DEMANDSRequires sitting, standing, and occasional light liftingEqual Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.