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Eligibility Specialist -

AppleOne Malden Full-Time
$16.00/ hour
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? The contractors for this project will be focused on making outbound calls to potential members. •Candidate must have call center experience and customer service experience. •Potential for a few of them to go perm for top performers who do well during the assignment. •Manager will conduct one large group interview for this role. •Monday through Friday •Manager needs 15 people for 9 am to 5:30 pm shift and 4 people for 10:30 am to 7 pm shift. •Please indicate in the resume and in the comments section which shift the candidate is wanting to work. •Manager will conduct a group interview for these roles. •7/15 is the start date which means the background will need to be completed no later than July 8th so we can hire them in work nexus and allow enough time for equipment to be ordered. Responsibilities •The Eligibility Document Coordinator is responsible for verifying, documenting and coordinating information needed to process applications and other Eligibility Operations assignments. •Conducts health insurance policy analysis, documentation verification, employer coordination and customer service while ensuring accurate data entry, validation and timely processing. •Provide enrollment assistance and HIPP/Premium Assistance program information over the phone to Medicaid eligible recipients and their family members. •Verify, document and investigate the presence of health care coverage for Medicaid recipients and their families. •Assist in the identification of members that may qualify for the HIPP/Premium Assistance program. •Complete periodic reports. •Customer service to include high volume of phone work answering questions and other inquiries regarding the HIPP/Premium Assistance program. •Data entry to include accurate and timely entry of information. •Obtain and/or verify all items related to eligibility and enrollment into the HIPP/Premium Assistance program. •Complete maintenance of active cases during open enrollment and premium review for check processing to assist with maintaining the revenue and program growth. Qualifications •High School Diploma or Equivalent •2+ years of experience in insurance industry, health care or government sponsored health insurance to include customer service and medical billing knowledge or similar math related experience. •2+ years of experience working on the phone making inquiries (outbound) and answering calls (inbound). •Knowledge of health care terminology is a plus. •Ability to organize well, communicate both verbally and in writing, fluently in English. •Flexibility and adaptability in the workplace. •Work with Microsoft Word and Excel and navigate internet skillfully. •Analyze information and use logic and process to address work-related issues and problems. •Perform data entry accurately. •Use of a PC, phone, 10 key, sorting, filing and other office machines. •Ability to handle conflict appropriately and constructively. •Working knowledge of HIPAA privacy and Security rules. We are an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, sex, sexual orientation, age (40 and over), gender identity, national origin, protected veteran status, disability or any other protected classification under federal and state law.
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Skills required

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Coordinate Program
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Job ID: CM23.135455


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Since 1964

On a journey around the world during the early 1960s, Bernard "Bernie" Howroyd had to work odd jobs in order to pay his way forward—selling encyclopedias in Australia to chocolates in Canada. Through these varied encounters, an incredible insight started to form in young Bernie’s mind: “No matter where people are from, no matter what language they speak, everyone deserves to be heard and respected.” Inspired and driven by this realization, he took that insight and started AppleOne Employment Services in Los Angeles in 1964.

Hiring Made Human

We at AppleOne have one true belief. We believe in people. Since 1964, we have connected the best people, their talents, skills, career goals, and aspirations with the best companies. We are "Career Gurus." We are "People-People." Let us introduce you!

AppleOne is part of the ActOne Family of Companies. Across our company groups—A-Check Global, AgileOne, and ATIMS—we are able to provide comprehensive services and technologies to our enterprise partners. Our integrity and quality of service is recognized by our ISO-9001:2008, IMAGE, and WMBE Certifications.

We have serviced Federal government over the years (including direct with FEMA). We are DCAA compliant. Recently, we formed a new corporation (ActOne Government Solutions, Inc.) specifically to service Federal government contracts.

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