Eligibility Processor II

Scottsdale AZ 85260 Scottsdale 2 15880 North Greenway

Job Description

Responsible for creation and maintenance of member and provider eligibility records. Research and reconcile authorization data to ensure accuracy. Perform manual entry of authorizations into various client systems. Comfortable with high degree of contact with case managers, client contacts, and providers.

Essential Functions


- Evaluates data and determines what process is required for specific systems and accounts.
- Processes member enrollment and change of coverage requests.
- Verifies provider contractual status.
- Corresponds with contacts regarding member and provider data.
- Resolves problems with automated transmission of authorizations.
- Responsible for timely and accurate keying of authorizations in client systems.

#LI-KB1

General Job Information

Title

Eligibility Processor II

Grade

16

Job Family

Customer Service Group

Country

United States of America

FLSA Status

United States of America (Non-Exempt)

Recruiting Start Date

10/2/2018

Date Requisition Created

10/2/2018

Minimum Qualifications

Education

GED (Required), High School (Required)

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

Minimum of 1 year customer service, claims, or general office.- Proficient with MS Office software.- Ability to type 60 WPM. - Strong ten key user.- Results and solution oriented; not afraid to ask questions

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