Eligibility processor I

Arizona, Utah

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.
  • 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.

General Job Information

Title

Eligibility processor I

Grade

15

Job Family

Customer Service Group

Country

United States of America

FLSA Status

United States of America (Non-Exempt)

Recruiting Start Date

8/12/2019

Date Requisition Created

8/12/2019

Work Experience

Claims, Customer Service

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 experience.
  • Proficient with MS Office software.
  • Ability to type 60 WPM.
  • Strong ten key user.
  • Results and solution oriented; not afraid to ask questions

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.

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