Eligibility Analyst

Quick Overview

• Position: Eligibility Analyst - $30/hour
• Start Date: Immediate openings available
• Company: Workwarp (representing Aeetna)
• Location: Remote
• Compensation: Competitive salary

Job Details

Position Rundown

As an Eligibility Analyst, you will play a vital role in ensuring accurate and timely eligibility determinations for our clients. You will be responsible for reviewing client information, updating records, and resolving eligibility-related inquiries. This role requires strong analytical skills, attention to detail, and excellent communication abilities.

Responsibilities

• Review client enrollment status, make necessary changes to records, and address a variety of eligibility feedback.
• Maintain up-to-date enrollment data and manage the flow of eligibility information.
• Utilize online resources to understand account designs and benefits, and potentially contribute to the improvement of these resources.
• Respond to, investigate, and resolve eligibility and other enrollment-related issues by collaborating with clients, brokers, and internal teams to achieve positive outcomes.
• Apply relevant considerations related to technical prerequisites, administrative/contractual arrangements, account designs, and benefit boundaries in addressing eligibility matters.
• Serve as a liaison between clients, brokers, and the IT department, clarifying and identifying business needs and solutions for non-standard scenarios.
• Ensure all transactions interface with downstream systems; test and approve data documents for new or existing clients using system tools and track results to prevent potential issues and improve ongoing support.
• Collaborate with other team functions to facilitate the delivery of eligibility, plan design, and benefit information.
• Complete required documentation and eligibility screens to implement system processing of plan benefits.
• Code system screens, policies, and designs to support downstream processes and the generation and delivery of member and plan support items.
• Ensure all communications with clients, external managers, and brokers, including sensitive member data, adhere to HIPAA consistency requirements.

Required Capabilities

• Excellent written and verbal communication skills, demonstrating the ability to interact professionally with both internal and external clients. This includes active listening, empathy, clear spelling, grammar, editing, and professional phone correspondence.
• Demonstrated ability to creatively solve problems and identify improvements.
• Proficiency with Microsoft Word, Excel, and Outlook.
• Strong data entry skills.
• Ability to understand goals/end states and work with minimal direction to achieve those expectations/end states.
• Ability to manage multiple tasks and shifting priorities.
• Ability to handle a high volume of work and manage diverse workflows.
• A collaborative individual capable of working independently when required.
• Ability to deliver accurate and timely results.
• Follow-up as needed to resolve issues successfully.
• Must work a hybrid schedule with three days per week in the office.

Preferred Capabilities

• Prior comparable experience is a plus.
• Secondary School certificate, G.E.D. or equivalent experience.

Join Our Team! This is a fantastic opportunity to grow your career. If you have the skills and passion we're looking for, please submit your application today.