Swoon is actively seeking an Eligibility Representative to join the team of our client - a Fortune 500 Company!
You'll be an integral part of the team - responsible for generating new membership into a Medicare Plan during the Annual Enrollment Period!
What will your day-to-day look like?
Responsible for determining plan eligibility and enrolling members within CMS regulatory guidance.
Work to save members with incorrect/incomplete applications by performing customer, physician and/or agent outreach and using support tools.
Maintain member demographic update and membership revalidation and apply eligibility requirements for membership changes.
Research and respond to eligibility inquiries as needed.
Ensures all enrollment eligibility is reconciled and maintained in accordance with CMS and departmental guidelines, requirements, regulations, policies, and procedures.
This position involves reviewing incoming applications, keying information into systems, determining eligibility, and saving submissions as needed.
Why do we love this company?
They have been recognized by organizations like Forbes and Human Rights Campaign for their commitment to diversity and inclusion.
They are consistently ranked high in J.D. Power awards for customer satisfaction in the health insurance category!
What's required?
1-2 years of data entry and enrollment/eligibility experience highly preferred
1-2 years of healthcare experience required
Experience with Medicare and state Medicaid highly preferred
Candidates with enrollment or eligibility experience will take priority
Proficient with Microsoft Office suite products
Advanced PC Skills required
Strong attention to detail
Critical thinking
Ability to work with minimal supervision
Excellent verbal and written communication skills
Strong Customer Service skills
Schedule Requirements:
Must be able to work 6am-2:30pm CST shift
Must have flexibility to work OT
What's next?
Apply Now!
Employment type
Contract
Job function
Health Care Provider and Customer Service
Industries
Insurance Agencies and Brokerages, Insurance, and Medical Practices
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