Eligibility Representative

Work at Home
Immediate

Job Description

Grow with a company that is passionate about helping you maximize your full potential. Become a part of transforming customer and client experience through the utilization of our innovative work from home technology. At BroadPath we believe in assuming the highest intention for others, our employees are empowered through their voices which helps us to continue shaping the emerging future, bringing innovation, and flexibility to the Work From Home Industry. Under the direction of the Supervisor, Eligibility Services, accurately maintain enrollment records based on daily requests received from the various internal and external stakeholders. This is a fast pace high volume role. The candidate should possess professional communication skills, written and verbally, and maintain a high level of confidentiality.

Responsibilities

  • Responsible for the accurate update and maintenance of enrollment records received electronically to facilitate the processing of claims and other service requests, in accordance with operational policies and daily production standards.
  • Maintain professional relations with HMO representatives, acting as a liaison between B&T and the HMO in resolving eligibility issues.
  • Process assigned eligibility reports to completion, accurately updating and maintaining enrollment records, in accordance with operational policies and procedures.
  • Ensures accurate and timely data entry into the IDX system for each patient, according to established standards.
  • Process electronic verification request from internal and external stakeholders.
  • Call and follow up with Healthcare Plans to resolve eligibility issues.
  • Properly analyzes various payor eligibility responses to find the information needed to complete verifications.
  • Follows all HIPAA, compliance, privacy and confidentiality standards.
  • Updates and maintains enrollment records of members. 
  • Performs other duties as assigned.

Basic Qualifications

  • High school graduate or an equivalent required.
  • IDX experience, required.
  • Claims experience required.
  • Adjudication experience required.

Preferred Qualifications

  • 1-2 years of work in Healthcare, preferred
  • 1-2 years customer services, preferred