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Eligibility Representative- Full Time - San Diego

Job ID JR144181 Date Posted 11/29/2023
San Diego, California
  • Corporate Offices
  • Day
  • Regular
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Responsibilities

Hours


Shift Start Time:

8 AM

Shift End Time:

5 PM

Additional Shift Information:

Weekend Requirements:

No Weekends

On-Call Required:

No

Hourly Pay Range (Minimum - Midpoint - Maximum):

$20.000 - $22.314 - $26.777


The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.  The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.



What You Will Do
Update eligibility data received from HMOs. Audit and correct data as needed. Work eligibility file edits. Perform special projects as directed.

Preferred Qualifications
  • H.S. Diploma or Equivalent
  • HMO and eligibility experience.

Essential Functions
  • Audit enrollment
    Accurately audit enrollment and complete on-line error corrections appropriately.
    Standard = 2% error corrections
  • Communication and teamwork
    Initiate Demonstrate cooperation/teamwork by participating in achieving department goals, promoting cooperation with co-workers and other departments, communicating courteously with co-workers, regularly attending and contributing to unit meetings, and accurate and timely submission of production reports and time cards.
    Standard = 0-2 documented incidents
  • Documentation and audits

    Complete audit & on-line error corrections from eligibility edit reports before next monthly update.
    Complete by next monthly update 95% of the time.
    Check for any claims or invoices that may have been affected by enrollment updates. Forward information to appropriate department for correction.
  • Special projects
    Standard: completed by due date 95% of the time.
  • Time management
    Demonstrate ability to work independently and manage time well with any free time used to help in other areas as directed. Inform supervisor when available for additional work assignments
    Standard = 0-2 documented incidents

Knowledge, Skills, and Abilities
  • Ability to type and 10 key by touch.
  • Excellent communication skills both oral and written.
  • Strong organizational skills. Prior office experience.
  • Familiar with operating a PC.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class


H.S. Diploma or Equivalent
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