Eligibility Coordinator - SCAN Temp
Core
Maintain SCAN Health Plan's core eligibility system by reconciling, entering, correcting, and deleting member information, and processing enrollment requests.
Role type
Eligibility Coordinator
Builds
Member enrollment data and eligibility reports for SCAN Health Plan
Domain
Healthcare / Insurance Eligibility
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
Data entry, regulatory compliance, outbound calling, report generation, data reconciliation, MS Office (Word, Excel, Outlook, Teams, PowerPoint)
Preferred skills
Knowledge of CMS regulations, problem solving
Technologies
IKA system, Federal systems, Enterprise Inbox, Department Queue
Responsibilities
Review member applications for deficiencies and assign codes; Enter member data including benefit assignment and billing information; Verify eligibility using state and Federal websites; Make high volume outbound calls to members to confirm enrollment information; Generate and distribute eligibility report mailings to providers; Perform daily reconciliations to resolve eligibility issues; Reconcile discrepancies between member data and various systems.
Seniority
Entry-level to Mid-level, minimal supervision