Eligibility Coordinator
On-siteGainesville, Georgia, United States
Job Summary
Coordinate member eligibility input for new groups and manage on-line portal user accounts. Enroll new members and process terminations while reviewing daily reports for corrections. Answer telephone calls regarding eligibility needs and handle escalated issues to ensure resolution. Maintain eligibility files for medical coverage recipients and ensure data integration on a daily basis. Perform quality assurance reviews and assist with go-lives and testing data files. Handle overflow phone support and pharmacy network tasks as assigned. Requires high school diploma, three years of customer service experience, and flexibility with scheduled hours.
Required Qualifications
- High school diploma or equivalent
- Minimum three years experience in a customer service position
- Excellent communication skills
- Ability to work effectively with clients, pharmacies, and plan members, internal and external contacts
- Proficient PC skills in Windows-based applications
- Ability to be flexible and quickly adapt to changing needs in department
- Must be highly organized
- Strong attention to detail
- Must be flexible with scheduled work hours
- Requires sitting
- Requires standing
- Requires occasional light lifting
Desired Qualifications
- Post high school or specialized training in medical field
- Health insurance background
- Knowledge of pharmacy terminology
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