Eligibility Coordinator Lead

Job description

Position Summary: Ensure that all EZCap system eligibility data is current and accurate. Researches and maintains systems and changes to existing eligibility in a timely manner. Essential Duties and Responsibilities include the following: - Performs research and analysis of membership - Enters new member eligibility records into EZ Cap in accordance with established guidelines. - Uses activity analysis reports from the health plans to make changes to existing enrollees; i.e. benefit option changes, terminations, and address changes. - Manually audits existing eligibility in EZ Cap against current eligibility. - Investigates retroactive cancellations for services rendered by the member after the policy termination date for eligibility guarantee. - Researches problem eligibility on authorizations and/or claims forms by calling the health plans or utilizing any other source to resolve the problem. - Assists personnel from other departments with eligibility issues. - Any other duties as assigned by Lead or Department Head. - Monitors queue, web site and email for inquiries. - Responds timely to membership inquiries - Perform other duties assigned by management. Organizational Responsib...