Remote Eligibility Research Specialist

American Specialty Health Incorporated; United States; Remote; USD 42,000 - 62,000; Full time

Job summary

American Specialty Health Incorporated (ASH) is seeking a Research Representative to join our Eligibility department. This role supports member eligibility verification, claims research, and provider communications from a remote home office.

You will work toward metrics such as 85 claims or 60 ASHLink requests daily with high accuracy, handle multiple research queues, and provide professional customer service.

Qualifications

• High School Diploma or GED required.
• 1 year experience with 10-key typing and computer skills; 8,000 keystrokes per hour required.
• Experience with claims processing or eligibility verification preferred.
• Excellent customer service skills with outbound calls and productivity/accuracy expectations.

Responsibilities

• Researches and resolves member eligibility requests.
• Maintain a minimum daily production level (e.g., 85 claims, 60 CSS/MNA, or 60 ASHLink) with ≥98% accuracy.
• Assist in multiple functions as needed; participate in peer mentorship.
• Verify member eligibility from various sources and input/save into logs.
• Provide professional customer service and handle inquiries and queues.
• Process research for ASHLink, MNA, and other areas within required turnaround times.
• Update records and resolve logs when research is complete.

Skills

10-key typing

Customer service

Outbound calls

Eligibility verification

Claims processing

IHIS

ASHCore

Education

High School Diploma or GED

Tools

IHIS

ASHCore

Job description

American Specialty Health Incorporated (ASH) is seeking a Research Representative to join our Eligibility department. This role supports member eligibility verification, claims research, and provider communications from a remote home office.

You will work toward metrics such as 85 claims or 60 ASHLink requests daily with high accuracy, handle multiple research queues, and provide professional customer service.