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Eligibility Processor I

Date Posted: 9/10/2019

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Job Description

Our healthcare company is in Maryland Heights, MO and is currently looking for a Eligibility Processor I.

Job summary:

Responsible for creation and maintenance of member and provider eligibility records. Research and reconcile authorization data to ensure accuracy. Perform manual entry of authorizations into various client systems. Comfortable with high degree of contact with case managers, client contacts, and providers.

Job Description:

  • Evaluates data and determines what process is required for specific systems and accounts.
  • Processes member enrollment and change of coverage requests. 
  • Verifies provider contractual status.
  • Corresponds with contacts regarding member and provider data.
  • Resolves problems with automated transmission of authorizations. 
  • Responsible for timely and accurate keying of authorizations in client systems.

Requirements/Certifications:
  • Minimum of 1-2 years in data entry, verification & claims experience required
  • High School Diploma/GED (Required)
  • Good computer skills, especially Excel
  • Must be able to work in Excel spreadsheets, have strong Excel knowledge
  • Be able to work in multiple databases/claims systems
  • Some research tasks required
  • Searching through databases
  • Does not need call center experience.  
  • Worker needs to able to work independently as the rest of the team will be working virtually.  
  • Training will be virtual, but candidate will sit in the office in Maryland Heights, MO.
  • Worker will be sitting in the Call Center but direct manager will be available virtually (from CA).

Benefits:

We put our Ambassadors first. When it comes down to it, we know we can't fulfill our Promise to our business customers without your com­mitment. You represent our organization while on assignment. In return, we do our best to show our commitment to you. Our Ambassador Benefits package includes: Medical, dental and vision coverage. It also includes 401k, sick time, holiday and much more. We are an equal opportunity employer.

We are an equal opportunity employer and make hiring decisions based on merit. Recruitment, hiring, training, and job assignments are made without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, or any other protected classification. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.

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Job Snapshot

  • Employee Type:Full-Time
  • Location:Maryland Heights, MO
  • Job Type:Other
  • Experience:Not Specified
  • Education:Not Specified
  • Date Posted:9/10/2019
  • Contact: Eva Rowe (972) 661-0015
  • Pay Range: $0.00 - $0.00 Annually
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Job Reference: JO-1909-69903