Coordinator II - Eligibility Consultant – Paper Ops

Job Title: Coordinator II - Eligibility Consultant Paper Ops

Location: Fully remote (US-based)

Duration:

Position Summary

We are looking for a detail oriented individual to join Medicare PCP Enrollment Validation Team.

Plan Sponsor Service Consultants (PSSC) support PCP and CSNP processes.

PSSC's are required to perform multi-system research, make outbound calls and process provider updates for new and existing members.

Key responsibilities include provider validation and alignment to our Medicare members, as well as outreach to obtain Verification of Chronic Condition.

The PSSC must be able to meet the demands of a high paced environment with tight turnaround times while maintaining quality metrics.

Our team is member centric and strives to provide excellent customer service to our members.

The PSSC will work collectively with teammates, leadership and other departments as needed in their role.

Responsibilities

Support PCP and CSNP processes.

Perform multi-system research, make outbound calls and process provider updates for new and existing members.

Perform provider validation and alignment to our Medicare members.

Perform outreach to obtain Verification of Chronic Condition.

Meet the demands of a high paced environment with tight turnaround times while maintaining quality metrics.

Work collectively with teammates, leadership and other departments as needed in their role.

Skills & Qualifications

High School Diploma, GED or Equivalent.

1-2 years of experience working with members and/or providers.

Basic healthcare background.

Previous knowledge of provider networks.

Outbound call experience.

Candidate must be proficient in Outlook, MS Excel and Word.

Excellent Communication Skills.

Experience working in a team setting.

Candidates can be located anywhere in the US, but pref. EST and CST.

Must work EST hours (preference given to EST-aligned candidates).

Private, dedicated workspace: Required.

Screenshot of internet speed: Required at submission.

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