Healthcare Eligibility Transactions Specialist

Hire Evolution Consulting; East Hartford (CT); On-site; USD 25,000 - 36,000; Full time

Job summary

Hire Evolution Consulting seeks a Transaction Processor Associate in Connecticut to process various transaction activities and projects. You will research, analyze, and verify consumer information using multiple systems, maintaining accuracy and efficiency in a fast-paced environment.

The role requires strong attention to detail, organization, and problem-solving skills, with reliable communication to clients and partners.

Qualifications

• Typing 40–45 wpm accurately.
• Prior experience in eligibility determination or transaction processing preferred.
• Healthcare benefits knowledge is a plus.

Responsibilities

• Maintain professional attitude when interacting with clients and partners.
• Process case maintenance transactions accurately per procedures and requirements.
• Research, review, and analyze consumer information to determine eligibility for medical programs and expenses.
• Communicate effectively with clients and partners via verbal and written correspondence.
• Screen consumers by entering and updating information in the Eligibility Determination System.
• Meet daily productivity standards for assigned tasks.
• Meet quality standards per the QA Plan focusing on accuracy and error prevention.
• Provide exemplary customer service to internal and external customers.
• Understand and follow policies, procedures, and operating systems related to responsibilities.
• Complete work within timelines and contractual requirements.
• Identify, research, and resolve discrepancies per procedures.
• Be punctual and prepared at the start of each shift.
• Demonstrate accountability and adaptability to changing business needs.
• Strive for high quality and productivity results.

Skills

Typing 40-45 wpm

Attention to detail

Communication

Education

Equivalent education and relevant work experience

Tools

Eligibility Determination System

Job description

Duration: 5 months with the potential to be extended or become permanent

Hours: 830am - 5pm

Days: Monday to Friday

Hourly Rate: $20.22

Onsite in E Hartford, CT

Position Objective

Reporting to the Transaction Processing Supervisor, the Transaction Processor Associate is responsible for processing a variety of transaction processing activities and projects. The position involves researching, analyzing, verifying, and updating consumer information using multiple systems and databases.

The successful candidate will demonstrate strong attention to detail, accuracy, organization, and problem-solving skills, while maintaining a positive and professional approach in a fast-paced work environment.

Primary Duties and Responsibilities

Maintain a professional and respectful attitude when interacting with Conduent employees, consumers, Access Health, DSS, and other business partners.

Process case maintenance transactions accurately and in accordance with established procedures, guidelines, and contractual requirements.

Research, review, and analyze consumer information to determine eligibility for applicable medical programs and expenses.

Communicate effectively with clients and business partners through verbal and written correspondence.

Screen consumers by accurately entering and updating information in the Eligibility Determination System.

Meet or exceed established daily productivity standards for assigned tasks.

Meet or exceed established quality standards as defined by the Quality Assurance Plan (QAP), with a strong focus on accuracy and error prevention.

Provide exemplary customer service to both internal and external customers and consistently respond to customer needs in a professional and timely manner.

Maintain a thorough understanding of the policies, procedures, processes, and operating systems required to perform assigned responsibilities.

Complete assigned work within established timelines and contractual requirements.

Identify, research, and resolve discrepancies or issues in accordance with established procedures.

Report to work on time and be prepared to perform assigned responsibilities at the beginning of each scheduled shift.

Demonstrate accountability, dependability, and a positive attitude toward assigned responsibilities and changing business needs.

Consistently work toward achieving the highest quality and productivity results.

Comply with all applicable company policies and procedures, including the Project Site Attendance Policy.

Perform other duties and responsibilities as assigned.

Experience & Education

Previous experience in eligibility determination, transaction processing, healthcare benefits, or a related field preferred.

Equivalent education and relevant work experience may be considered.

40-45wpm accurate typing required.

Required Skills & Abilities

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below

Must be able to undergo and pass a background check and drug screen.

Note: a typing test will be required during the interview process.