Eligibility Analyst

Responsibilities

Acting as a healthcare data subject matter expert on Eligibility guidelines and Electronic Data Interchange (EDI) protocol for clients

Researching and consulting to improve healthcare data integrity and ensure excellent service delivery

Constantly improving healthcare analytical skills that are needed to perform data analysis

Resolving data enrollment issues on a daily basis

Consulting on healthcare data needs

Having exceptional time management and healthcare client management skills

Continuous development training will be provided in this role to ensure the Eligibility Analyst is able to exceed client expectations in this fast-paced environment

Qualification

Required

1+ year(s) in healthcare data eligibility, insurance, IT, benefits, or data analytics environment with a strong ability to work independently, problem solve, and analyze data in a confidential healthcare environment

2+ years customer service experience in a fast-paced environment

Strong written and verbal communication skills

Ability to communicate with business clients and stakeholders in a professional manner

High School Diploma (required)

Preferred

3+ years experience in eligibility or other relevant background

Experience in EDI (Electronic Data Interchange)

Understanding of the PBM industry

Familiarity with RxClaim and/or AS400

Pharmacy technician or benefits verification experience

Associate's degree or 2 years of PBM or healthcare experience (preferred)

Benefits

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Other resources, based on eligibility