Eligibility Specialist

Job Summary

A company is looking for an Eligibility Specialist responsible for administrative processing of client enrollments and maintaining eligibility updates.

Key Responsibilities

• Process transaction types including adds, terminations, and changes related to eligibility
• Review and process enrollment transactions in accordance with relevant documentation
• Produce reports for auditing and processing purposes and track enrollment data for continuous quality improvement

Required Qualifications

• Outstanding organizational and time management skills
• Knowledge of Electronic Data Interchange (EDI) file updates and healthcare eligibility procedures
• Proficient in Microsoft Office Suite, Google Workspace, and Adobe
• Experience with CRM software, preferably Salesforce
• Bachelor's or associate degree plus 3 years of administrative experience or equivalent education and experience