Our Client, a Retail Pharmacy company, is looking for a Coordinator II - Eligibility Consultant – Paper Ops for their Remote location.
Responsibilities:
Handles physical documents and paper records to verify the eligibility of patients or members for healthcare services.
Reviews paper forms, applications, or supporting documentation to gather and validate information such as insurance coverage, demographic data, and eligibility criteria.
Organizes paper-based eligibility documents by creating and maintaining filing systems, ensuring proper document storage, and implementing strategies to improve accessibility and retrieval of information.
Analyzes the paper-based information and documentation to determine the eligibility of patients or members for healthcare services.
Performs manual data entry tasks to input eligibility information into relevant systems or databases.
Ensures compliance with relevant healthcare regulations, policies, and industry standards in relation to paper-based eligibility operations to maintain patient confidentiality.
Identifies opportunities to enhance the efficiency and accuracy of paper-based eligibility operations.
Follows regular, timely feedback as well as the formal performance review process to ensure delivery of exceptional services and engagement, motivation, and personal development.
Generates reports and analyzes data related to paper-based eligibility operations to help improve processes, address bottlenecks, and support decision-making.
Requirements:
Customer Service experience.
Attention to detail and accuracy.
Problem solving skills.
Strong organization skills.
Understands the impact of work to other teams and downstream support areas.
Ability to analyze and research data to make appropriate corrections as necessary.
Strong verbal and written communication skills.
Workplace flexibility - ability to adapt to change
Preferred Qualifications:
Knowledge of Health Care and/or MCO’s.
Knowledge of Enrollment.
Knowledge Medicaid and/or Medicare.
Knowledge and comfortability with learning different systems and using Excel
Experience
At least 1 years of overall related experience of Center for Medicare/Medicaid Services (CMS) guidelines for Medicare Part D enrollment processes or previous work experience in regulatory environment Dependable/Responsible/Accountable Excellent spoken and written communication skills Capable of managing through transition, while fostering a positive team environment Confident in decision making ability within strict timelines Exceptional prioritization and organizational skills Acts with integrity and uses sound judgment in dealing with confidential information