Immediate need for a talented Eligibility Representative. This is a 04+ months contract opportunity with long-term potential and is located in U.S(Remote). Please review the job description below and contact me ASAP if you are interested.
Job ID: 26-22422
Pay Range: $19/hr - $19.35/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
Key Responsibilities:
- Process and maintain eligibility and enrollment transactions, including updates, corrections, and reconciliations of member data
- Review and analyze eligibility reports to identify discrepancies and ensure accurate resolution
- Implement and maintain data across automated systems, direct connections, and manual workflows
- Verify eligibility and ensure compliance with Medicare guidelines and regulatory requirements
- Partner with internal teams (e.g., systems, operations) to investigate and resolve data or processing errors
- Perform detailed data entry and validation tasks with a high level of accuracy and timeliness
- Monitor transaction outputs to ensure completeness and adherence to established standards
- Important Role Clarification
- This role is not primarily customer service-based and does not focus on call handling. This role is customer focus , not customer service . We don t speak to members at all really.
- Responsibilities center on processing enrollment transactions and eligibility data, which require strong analytical skills and attention to detail
- Verifying eligibility and processing enrollment applications/transactions are distinct functions, with this role emphasizing transaction processing and data integrity
Key Requirements and Technology Experience:
- Working knowledge of Medicare Advantage enrollment and eligibility (Part A, Part B, and Part C)
- Strong analytical and problem-solving skills with a data-focused mindset
- High attention to detail and ability to manage large volumes of transactional work
- Proficiency in Microsoft Office Suite (especially Excel)
- Ability to work independently with minimal supervision
- Strong written communication skills for internal collaboration
- 1+ year of experience in healthcare insurance
- 1+ year of experience in enrollment and eligibility processing (Medicare Advantage preferred)
- Prior experience with data entry, enrollment systems, and transaction processing
Our client is a leading Health insurance Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
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