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Job Details:
Position Name : Eligibility Representative/Managed Care Claim Support/Sharp Healthcare/Day Shift/Full Time
Location: San Diego, CA
Job ID : 88251f22412cef25
Description : [H.S. Diploma or Equivalent
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
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