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Eligibility Data Specialist

RetireeFirst
On-site
Mount Laurel, New Jersey, United States
$24 - $28 USD hourly

Job Details

Labor First HQ - MOUNT LAUREL, NJ
$24.00 - $28.00 Hourly

Description

Summary of Position:


Responsible for activities related to insured member eligibility, enrollment, and member onboard communication, which includes eligibility data file and case management to ensure processed updates are accurate and compliant with Centers for Medicare and Medicaid (CMS) with standardized internal/external required formats.


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Duties & Responsibilities:

















  • Processes initial eligibility and updates according to client and/or carrier specifics

  • Handles and manipulates data files in excel, txt, and other formats with adherence to information security and best practice processes for data file loading integrity

  • Quality checks eligibility and enrollment updates and member communications to ensure seamless onboarding experience and CMS compliance

  • Communicates clearly through multi-channels on actions taken, next actions and status to support transparent understanding of eligibility and enrollment progress

  • Develops, evaluates and modifies processes and best practice methodologies at client and carrier levels to support continuous improvement

  • Responsible for data integrity in all manners of eligibility and enrollment processing

  • Adheres to strict policies and procedures, as our processes require CMS and carrier compliance

  • Interacts with members when needed to support enrollment or disenrollment processing




Qualifications

Licensing & Qualifications



  • Intermediate Knowledge of Microsoft Excel and Data Management

  • High School Diploma or Equivalent

  • Life and Health Producer’s License (within 9 months of onboarding)

  • Exceptional attention to detail


Preferred Qualifications



  • 3-5 years of related customer service experience

  • Experience working with Insurance Carriers

  • Knowledge of Salesforce.com