Posted 1 week ago

Eligibility Coordinator

Company: Innovista Health Solutions
Category: Customer Service, Office and Administration

 Oak Brook

Type: Full Time

Innovista Health Solutions has an opening for the Eligibility Coordinator position. The Eligibility Coordinator organizes, maintains, and updates eligibility information. Uses proprietary company software (EZ Cap, EZ Net, and Eligibility Manager) to maintain the integrity of the member database regarding eligibility. Provides general support to other departments as they relate to eligibility issues. DUTIES AND RESPONSIBILITIES:

  • Download and maintain eligibility data from health plans using websites, discs, and ftp.
  • Enroll and update member records based on the weekly/monthly database file.
  • Interact with Customer Service Department staff to resolve complaints related to eligibility.
  • Interact with the Customer Service Department staff to verify member eligibility.
  • Investigate and research complex eligibility issues to facilitate a resolution.
  • Provide data management and data entry to ensure the database is readily usable to support the activities of other working groups.
  • Perform testing of system updates prior to implementation to ensure accuracy and facilitate an efficient transition to production.
  • Keep supervisor apprised of all system and client issues.
  • Provide support to other working areas as needed.
  • Communicate and interact effectively and professionally with co-workers, management, customers, etc.
  • Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
  • Maintain complete confidentiality of company business.