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Eligibility Specialist

Summary of Position

As an Eligibility Specialist you’ll work on a key process within our business model, researching data and maintaining accuracy in our member database. You’ll resolve eligibility inquiries, partnering with other cross-functional departments and communicating key information in a timely manner. Your efforts will help us increase efficiencies and scalability as Teladoc Health adds new members, products, and technical functionality.

We’re looking for a true go-getter with exceptional Excel and communication skills and the professional maturity to work productively under tight deadlines, especially on the last days of the month and each quarter. If you have an eye for detail and a natural drive for putting order to the world around you, we want to meet you! Apply today.

Essential Duties and Responsibilities

  • Perform comprehensive research in multiple systems to verify accurate member eligibility
  • Maintain accurate member eligibility status in our database
  • Work with clients and partners to verify insurance coverage for all members
  • Resolve eligibility inquiries and communicate outcomes to other departments while keeping to established timelines
  • Take shifts enrolling Teladoc Health members on the last day of the month/quarter (which could possibly fall on a weekend day)
  • Review and correct eligibility data in our records, ensuring accuracy
  • Resolve pending member registrations
  • Reconcile reports and maintain eligibility status records in Excel
  • Perform extensive data entry
  • Maintain knowledge of industry standards for insurance verification
  • Understand and adhere to HIPAA policies, procedures, and regulation, maintaining strict confidentiality
  • Participate in special projects and provide ad hoc analytical eligibility support as needed
  • Meet quality and performance standards for all eligibility projects

Qualifications Required for Position

Those qualifications needed such as certification, training, experience, or knowledge skills.

  • Advanced Excel skills, with the demonstrated ability to write formulas, perform VLOOK pivot tables, etc.
  • The ability to accurately calculate figures and reconcile accounts
  • Knowledge of EDI 270/271 transactions and insurance eligibility verification
  • Strong verbal, written and interpersonal skills, with an affinity for teamwork
  • Good organizational, multi-tasking and time management skills, with excellent attention to details
  • Comfort and success working in a fast-paced environment with tight deadlines
  • A strong work ethic, resourcefulness and motivation to succeed
  • A proactive approach to identifying and resolving issues
  • A college degree or equivalent real-world experience in a related field