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Eligibility Coordinator job in Fresno at PrideStaff

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Eligibility Coordinator at PrideStaff

Eligibility Coordinator

PrideStaff Fresno, CA, CA Full Time
$14.00 - $17.50/Hour
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Title: Eligibility Coordinator

Handling internal and external inquiries regarding eligibility status, benefits, co-payments, co-insurance, deductibles, etc. thru internal system, plan website, designated portals and/or thru direct contact with the plans; Documenting inquires and responses in the system and making changes to member records per department policy and guideline;

Essential Duties and Responsibilities

  • Handles phone calls professionally and courteously
  • Documents member or provider calls in the system.
  • Utilizes available resources to verify and document co-payment, coinsurance and deductible amounts due at time of service.
  • Updates eligibility information - makes additions, changes, and terminations timely and accurately.
  • Advises management on issues and opportunities regarding workflows.
  • Fixes EDI errors of “Member Can’t Find”.
  • Maintains all practices to protect PHI and follow HIPAA guidelines.
  • Performs other duties/projects as assigned

Qualifications:

  • Good verbal and written communication skills
  • Good customer service and problem-solving skills
  • Knowledge of managed care and HMO products
  • Knowledge of medical terminology
  • Proficient in Microsoft applications

Job Type: Full-time

Experience: Minimum 2 years of healthcare-related experience

Experience:

  • Medical Terminology: 2 year (Preferred)
  • Microsoft Office: 1 year (Preferred)
  • Managed Care: 1 year (Preferred)

Education:

  • High school or equivalent (Preferred)

IF YOU ARE INTERESTED AND QUALIFIED, PLEASE APPLY IMMEDIATELY.  QUESTIONS CAN BE DIRECTED TO CRISTINA DAVIS AT

559-540-2600
.

Recommended Skills

  • Complex Problem Solving
  • Communication
  • Insurance
  • Health Care
  • Managed Care
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