Eligibility Coordinator - SCAN Temp

SCAN; United States; Remote; USD 23,000 - 29,000; Part time

Benefits offered by this job

Mostly Remote

Medical Benefits

Paid Sick Time

401(k) Retirement Plan

Employee recognition program

Job summary

SCAN is seeking an Eligibility Coordinator for our SCAN Health Plan in a remote, temp capacity. You will maintain core eligibility data by reconciling, entering, correcting, and deleting member information to ensure accurate enrollment and compliance.

You will review applications, verify enrollment eligibility on state and federal platforms, and perform data entry in the IKA system while following CMS regulations. This role offers mostly remote work and benefits.

Qualifications

• High School Diploma or equivalent required.
• 0-3 years of related experience preferred.
• Provides leadership, coaching, and/or mentoring to a subordinate group. May act as a lead or first-level supervisor.
• MS Office proficiency required (Word, Excel, Outlook, Teams, PowerPoint).

Responsibilities

• Processes member applications by reviewing data for deficiencies; assigning codes to data; establishing data entry priorities, and resolving discrepancies by using departmental policies and procedures.
• Enter member data by inputting alphabetic and numeric information into IKA system including benefit assignment and provider selection.
• Verify eligibility for enrollment using state and Federal websites and CMS regulations.
• Provide excellent customer services by making a high volume of outbound calls to members to clarify, obtain, and confirm information.
• Prepare eligibility report mailings and member correspondence within defined timelines.
• Reconcile discrepancies between member data and various systems.

Skills

0-3 years experience

Problem Solving

Communication

MS Office proficiency

Education

High School Diploma or equivalent

Tools

MS Office (Word, Excel, Outlook, Teams, PowerPoint)

Job description

Remote

The Job

The Eligibility Coordinator - SCAN Temp will maintain SCAN Health Plan's core eligibility system by reconciling, entering, correcting, and deleting member information.

You Will

• Processes member applications by reviewing data for deficiencies; assigning codes to data; establishing data entry priorities, and resolving discrepancies by using departmental policies and procedures Research eligibility rejected transactions by identifying discrepancies and report findings to the appropriate business area
• Enter member data by inputting alphabetic and numeric information into IKA system according to screen format including benefit assignment, group affiliation, and provider selection, billing information, revenue codes and appropriate cross references Ensure regulatory compliance by following departmental desktops, policies and procedures, by adhering to state and Federal regulations and requirements
• Verify eligibility for enrollment using state and Federal websites Assist co-workers by training, updating processes, and assisting with job duties
• Provide excellent customer services by making a high volume of outbound calls to members to clarify, obtain, and or confirm information needed to successfully complete member’s enrollment request Represent the department by attending meetings, trainings, and process improvement teams The ability to accurately interpret and explain eligibility and CMS regulations and requirements in person, via email or telephonically
• Complete requests received through Enterprise, Department Inbox, and Department Queue by responding appropriately and in a timely fashion to internal and external customers; by answering telephonic and written inquiries concerning eligibility issues; following department policies and procedures; by professionally representing the department to others Maintain professional and technical knowledge by utilizing access to SCAN University on-line trainings, attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies
• Prepare eligibility report mailings by generating, reviewing and distributing eligibility information to providers within defined timelines Contribute to team effort by accomplishing related results as needed
• Prepare member correspondence by creating, triggering, printing, reviewing and mailing
• Assure accurate data from regulatory system reply by utilizing Federal systems and other departmental systems to run reports and collect and analyze data for any necessary updates
• Responsible for daily reconciliations, in an effort to resolve member eligibility Issues by analyzing, correcting or updating data received on daily claims error report, unassigned PCP list and Incomplete Queue
• Reconcile discrepancies, between member data and various systems

We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.

Actively support the achievement of SCAN’s Vision and Goals.

Other duties as assigned.

Your Qualifications

• High School Diploma or equivalent experience required.
• 0-3 years of related experience.
• Performs work under minimal supervision.
• Handles complex issues and problems, and refers only the most complex issues to higher-level staff.
• Possesses comprehensive knowledge of subject matter.
• Provides leadership, coaching, and/or mentoring to a subordinate group. May act as a lead or first-level supervisor.
• Technical expertise - Basic technical skills for functional area. MS Office - Word, Excel, Outlook, Teams, PowerPoint experience required.
• Problem Solving - Basic problem solving skills.
• Communication - Good verbal and written communication and interpersonal skills.

SCAN Temp

What's in it for you?

• Base Pay Range: $17.00 to $21.00 per hour
• Work Mode: Mostly Remote
• Medical Benefits
• Paid Sick Time
• Excellent 401(k) Retirement Saving Plan
• Robust employee recognition program
• An opportunity to become part of a team that makes a difference to our members and our community every day!

At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.

SCAN is proud to be an Equal Employment Opportunity and Affinity Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.