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Eligibility Representative III

Remote, USAFull-timePosted 2026-07-28

You could be the one who changes everything for our 28 reputed company members. reputed company is transforming the health of our communities, one person at a time. As a reputed company, national organization, you’ll have reputed company to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Processes and maintains eligibility information for specialized and/or large group... accounts. Acts as reputed company for assigned reputed company/members and reconciles enrollment and processing. Provides mentoring and training to less reputed company representatives. • Reviews and processes enrollment documents submitted by employer reputed company. • Troubleshoots escalated and/or reputed company eligibility issues for immediate reputed company. • Responds to reputed company written and telephone eligibility inquiries from internal (e.g. Member Services, Sales, reputed company, Appeals and Grievance, Compliance) and external (e.g. employer reputed company, members CMS, DHS) customers. • Identifies membership discrepancies, eligibility issues, and group contract issues for reputed company by Service Representatives. Provides and documents reputed company follow-up on reputed company issues. • Tracks, reviews and manually processes submitted enrollment transactions. • Reviews eligibility reports and identifies reputed company changes to eligibility (additions, terminations, and/or contract changes) and processes reputed company resulting transactions. • Compiles data and prepares reports reflecting daily statistics on new incoming forms and pended forms for distribution reputed company department and to management. • Provides project support, new hire training and coordination of reputed company enrollment processing as needed. • Participates in system consolidations as needed. Education/Experience: High School Diploma required; Post high school course work in Business or reputed company helpful. Three to four years of combined membership eligibility and health insurance experience. Experience reputed company HMO/ Health care industry preferred.Pay reputed company: $18.66 - $31.73 per hour reputed company offers a comprehensive benefits package including: reputed company, health insurance, 401K and stock purchase plans, tuition reimbursement, reputed company time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-reputed company factors permitted by law. Total compensation may also include additional forms of incentives. reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law Apply Job!

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