AlhambraRecruiter Since 2001
the smart solution for Alhambra jobs

ELIGIBILITY COORDINATOR

Company: Network Medical Management Inc
Location: Alhambra
Posted on: January 12, 2021

Job Description:

SUMMARYOrganizes, maintains, and update Ez-Cap eligibility information. Makes sure members' eligibility is up-to-date in Ez-Cap from contracted Health Plans, checks health plan web sites and contacts Medi-Cal and Medicare offices. Handles checking eligibility, benefits, co-pays for authorization and claims department. Tracks work by keeping accurate logs of all the different projects of maintaining member eligibility. Working on conflicts and rejects related to members' eligibility. Assists internal representatives with any eligibility questions. Support other various projects as assigned by lead or director.ESSENTIAL DUTIES AND RESPONSIBILITIES, include the following:* Assume day-to-day administrative responsibilities related to Eligibility.* Contact various health plans to verify member eligibility with the plans and IPA's.* Download and maintain data from Health Plan either through web site, discs, ftp sites and any other ways data is Transmitted.* Check membership from various sources using Datatug, checking web sites manually, or calling health plans directly.* Monthly rejects and conflicts for members that needed to be added and termed in the system for monthly capitation run.* Assists the claims department to verify eligibility and other health coverage from the health plans.* Assists with EDI and Member Can't find of claims sent in from providers.* Assists with daily phone queue from providers, members and vendors related to eligibility and capitation.* Research member additional insurance such as dual, Medicare, Medi-Cal, and CCS. Document in Ez-Cap.* New providers' membership not on E-list will be manually inputted.* Other duties may be assigned.QUALIFICATIONSTo perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.* Intermediate knowledge of MS Word, Excel, Access and basic medical terminology is required.* Ability to understand and work with proprietary software applications.* Organizational ability and ability to exercise good judgment.* Typing speed 40+WPM and knowledge of 10 key desired.EDUCATION and/or EXPERIENCEOne to two years related experience and/or training; or equivalent combination of education and experience. Bachelor's degree (B.A.) from four-year College or university will be suitable as well.

Keywords: Network Medical Management Inc, Alhambra , ELIGIBILITY COORDINATOR, Other , Alhambra, California

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Other Jobs


Residential Loan Underwriter
Description: Seeking REMOTE Residential Underwriters with experience in reviewing all residential loan applications for compliance
Company: Caliber Home Loans
Location: Rowland Heights
Posted on: 01/21/2021

Pick, Pack, and Shipper
Description: A large cabinet manufacturer is hiring. We are seeking motivated, certified, forklift workers to be part of a great team Responsibilities: ul li Working independently
Company: Bluecrew
Location: Rowland Heights
Posted on: 01/21/2021

Food Delivery - Weekly Pay
Description: Job DescriptionDeliver with Uber. Earn on your schedule. Work on your schedule. Deliver for a few hours in the mornings, every night, or just on weekends--it's up to you. Earn Good Money. You'll
Company: Uber Eats
Location: San Gabriel
Posted on: 01/21/2021


Amazon Team Member - Earn up to $600 a week - Eastvale
Description: Warehouse Team Member Part-Time, Full-Time, Flexible Hours Shifts:Overnight, Day, Evening, WeekendLocationEastvale, Jurupa Valley, Mira LomaJob opportunities vary by location. We update postings daily (more...)
Company: Amazon Workforce Staffing
Location: Placentia
Posted on: 01/21/2021

Postmates - Earn Extra Cash
Description: Job DescriptionPostmates has the largest on-demand fleet in the U.S. with 200,000 Postmates, and an equally extensive network of merchants. While some companies try to build a warehouse outside of a city (more...)
Company: Postmates
Location: Placentia
Posted on: 01/21/2021

Residential Loan Underwriter
Description: Join a reputable mortgage company that offers a direct hire, six-figure income opportunity with
Company: Caliber Home Loans
Location: Paramount
Posted on: 01/21/2021

In Home Care Companion
Description: If you're someone who wants to work somewhere that you enjoy spending your time, we have the In Home Caregiving position for you Care In Homes believes that
Company: CareInHomes
Location: Placentia
Posted on: 01/21/2021

Supervisor - Hiring Immediately
Description: Flame Broiler - Supervisor ul li 19-25/hr li 15091 Newport Avenue, Tustin, CA 92780 We offer: ul li Flexible work schedules li Healthcare benefits li Meal discounts li
Company: Landed
Location: Placentia
Posted on: 01/21/2021

Residential Loan Underwriter
Description: Seeking REMOTE Residential Underwriters with experience in reviewing all residential loan applications for
Company: Caliber Home Loans
Location: Rosemead
Posted on: 01/21/2021

Amazon - Picker Packer - Immediate Hire (Eastvale)
Description: Warehouse Team Member Part-Time, Full-Time, Flexible Hours Shifts:Overnight, Day, Evening, WeekendLocationEastvale, Jurupa Valley, Mira LomaJob opportunities vary by location. We update postings daily (more...)
Company: Amazon Workforce Staffing
Location: Placentia
Posted on: 01/21/2021

Log In or Create An Account

Get the latest California jobs by following @recnetCA on Twitter!

Alhambra RSS job feeds