Integrated Resources
Job Title: Eligibility Consultant
Location: Remote, CT 06156
Duration: 6 Months+
Pay Range: $19.10/Hour. on W2
Schedule: Monday-Friday, 8:00 AM - 8:00 PM
Position Summary: The Contractual Eligibility Consultant supports Healthcare's enrollment operations by researching and validating member enrollment information, processing enrollment transactions, handling member inquiries, and participating in enrollment-related projects. This temporary role also includes outreach to members to obtain missing or required enrollment documentation and supports training and process improvement efforts.
Key Responsibilities: Handle physical documents and paper records to verify member eligibility for healthcare services. Review applications and supporting documentation to validate insurance coverage, demographic data, and eligibility criteria. Organize and maintain filing systems for paper-based eligibility documentation. Analyze paper-based documents to determine eligibility status. Perform manual data entry into internal systems and databases. Ensure compliance with healthcare regulations and internal confidentiality standards. Identify and suggest improvements to paper-based processes for greater efficiency and accuracy. Generate reports and analyze data to support decision-making and process optimization. Participate in training sessions and performance feedback meetings. Make outbound calls to members to obtain missing or clarifying information regarding enrollment.
Required Qualifications:
Candidates must reside in EST or CST time zones. Verifiable High School Diploma or GED. Basic skills in MS Excel, MS Word, and Outlook. Minimum of 1 year of experience related to CMS guidelines for Medicare Part D enrollment processes, or prior work in a regulatory environment. Dependable, responsible, and accountable work ethic. Participation in virtual trainings and meetings (camera on required). Completion of all required training within specified deadlines. Willingness to cross-train across platforms and products to support enrollment metrics. Adherence to all established workflows and departmental processes. Ability to monitor and minimize personal errors (OMT, avoidable rejections, found errors).
Preferred Qualifications:
Strong organizational skills and attention to detail. Effective communication, interpersonal, and problem-solving skills. Ability to maintain positive working relationships and exercise sound judgment. Familiarity with call recording systems is a plus.
Pay Range: $19.10/Hour. on W2
Schedule: Monday-Friday, 8:00 AM - 8:00 PM
Position Summary: The Contractual Eligibility Consultant supports Healthcare's enrollment operations by researching and validating member enrollment information, processing enrollment transactions, handling member inquiries, and participating in enrollment-related projects. This temporary role also includes outreach to members to obtain missing or required enrollment documentation and supports training and process improvement efforts.
Key Responsibilities: Handle physical documents and paper records to verify member eligibility for healthcare services. Review applications and supporting documentation to validate insurance coverage, demographic data, and eligibility criteria. Organize and maintain filing systems for paper-based eligibility documentation. Analyze paper-based documents to determine eligibility status. Perform manual data entry into internal systems and databases. Ensure compliance with healthcare regulations and internal confidentiality standards. Identify and suggest improvements to paper-based processes for greater efficiency and accuracy. Generate reports and analyze data to support decision-making and process optimization. Participate in training sessions and performance feedback meetings. Make outbound calls to members to obtain missing or clarifying information regarding enrollment.
Required Qualifications:
Candidates must reside in EST or CST time zones. Verifiable High School Diploma or GED. Basic skills in MS Excel, MS Word, and Outlook. Minimum of 1 year of experience related to CMS guidelines for Medicare Part D enrollment processes, or prior work in a regulatory environment. Dependable, responsible, and accountable work ethic. Participation in virtual trainings and meetings (camera on required). Completion of all required training within specified deadlines. Willingness to cross-train across platforms and products to support enrollment metrics. Adherence to all established workflows and departmental processes. Ability to monitor and minimize personal errors (OMT, avoidable rejections, found errors).
Preferred Qualifications:
Strong organizational skills and attention to detail. Effective communication, interpersonal, and problem-solving skills. Ability to maintain positive working relationships and exercise sound judgment. Familiarity with call recording systems is a plus.