Job Details

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Eligibility Unit Representative - Hybrid Remote
Job ID:00004H63
Location:CA Santa Barbara
Hours:40 Monday Friday 8AM to 5PM
Pay:$20.00 $24.00
Great hybrid remote opportunity in managed care
Job Description
Will provide support to the Lead Eligibility Representative department staff for all eligibility membership functions relating to enrollment, disenrollment and reconciliation processes for all Company Health Programs. This position provides primary eligibility queue support and service for the Plans provider network, community based organizations, and government agencies such as DSS, SSA, TCRC, CCSCHDP and County Foster Children. The Eligibility Representative is proficient in member eligibility and provides support for the Member Services Department.This position is the primary contact in the Eligibility Queue for the Plans PhysicianProvider network, CBOs, and government agencies as noted above which includes responding to correspondence requesting eligibility verification and must maintain the established metrics that include 5.50 hours of coverage in the Eligibility queue Processing 100 of site to site PCP change selections received via fax Log billing issue receipts with appropriate file preparation for Billing Coordinators Backs up the Eligibility Unit Clerk as needed Provides support to the Lead Eligibility Representative Sets up and distribute the provider recap report for all programs Perform other duties or special projects as assigned by the Member Services Operations Manager andor Associate or Department Director
Skills Required
AA Degree or a minimum of 3 three years equivalent experience in a customer service environment Knowledge of the Medi-Cal and Social Security programs
Skills Preferred
Location Preferably local, hybrid schedule 2x a week Santa Barbara officeExperience in a customer service environment preferably in health care or managed care