Eligibility Specialist
Kforce Inc.

Job Info

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RESPONSIBILITIES:

A Kforce client is seeking to hire an Eligibility Specialists in Irvine, California (CA). Responsibilities includes:

• The Eligibility Specialist will assist in producing electronic spreadsheets and/or reports for audit and processing purposes
• Eligibility Specialists will research and correct cash application issues in HCPS
• Determine/correct out of balance ledger items on accounts
• Contact clients to explain and to resolve billing/payment discrepancies
• Verify/authorize refunds for terminations and/or overpayments
• Maintain a HIPAA compliant workstation and utilize appropriate security techniques to ensure HIPAA required protection of all confidential/protected client and enrollee data
• As an Eligibility Specialist, you will consistently meet processing cycle time standards and production due dates as set forth by management
• Assist in supporting with clients to facilitate payments on time and for the billed amount
• Eligibility Specialists will provide timely and effective customer service to clients for requests, inquiries or issues concerning enrollment, and/or billing items on their account
• Interface effectively with internal departments and external vendors, brokers, or other business contacts to coordinate interrelated activities and to resolve eligibility and/or billing issues as they arise
• The Eligibility Specialist will serve as representative displaying professionalism, knowledge, customer service and discretion in all interactions with other members and their customers

REQUIREMENTS:

• Intermediate Microsoft experience
• Computer required
• To be considered for this position, candidates must have experience in a similar role, or they must possess significant knowledge, experience, and abilities to successfully perform the responsibilities listed
• Relevant education and/or training will be considered a plus

Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status

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