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Eligibility Specialist

Company: Versant Health
Location: Rancho Cordova
Posted on: January 7, 2021

Job Description:

Eligibility Specialist
Rancho Cordova, CA, USA Req #1450
Friday, October 16, 2020
Eligibility Specialist
Versant Health bringing you Davis Vision and Superior Vision is a leading provider of vision and eye health solutions. We offer a full spectrum of services in the vision care marketplace. Our mission is very real to our members: we help them enjoy the wonders of sight through healthy eyes and vision. What you do as a Versant Health Associate matters. 33 million Americans count on us to provide access to annual eye exams and corrective eyewear. We are here to change the face of vision care, and together we will make this happen.

Great Environment
We are dedicated to you- we provide a professional work environment, competitive benefits, equal opportunities and potential to grow with us. We guide you to what's right for you- as leaders in the industry, we guide and coach Associates to give them opportunities to reach their full professional potential. We think ahead for you- you'll enjoy a variety of benefits for those times when you need extra support.
Scope and Purpose of Position
The Eligibility Reporting Specialist (ERS) is responsible for eligibility error reports for groups that submit information via a variety of acceptable EDI transmissions. The ERS will manually correct any items from the exception report after the data is loaded into the HSP system and create and deliver error reports to our Trading Partners for review. In addition, the ERS will work with Trading Partners and the EDI Specialists to resolve errors and manually correct records in HSP at the direction of the Trading Partners.

Essential Functions

  • Work EDI load reports and create resulting error reports to Trading Partners within industry standard guidelines. Weekly productivity reporting is required
  • Update member records in HSP with accuracy and attention to detail in order to maintain fidelity of member data for all Trading Partners
  • Work with EDI Specialists and Eligibility Manager on escalated EDI errors to achieve resolution of persistent EDI errors for all Trading Partners
  • Demonstrate proficiency and accuracy in Data Entry Skills
  • Process emails, phone calls, faxes and other support communications in a timely and professional manner. Record keeping for audit trail is essential
  • Assist with implementation of new groups as assigned by Eligibility Manager or EDI implementation team members
  • Assist with implementation of EDI changes for existing groups
  • Partner with Client Management and the EDI team to meet and exceed customer's service expectations
  • Provide excellent customer service and handle all customers in a professional and courteous manner
  • Good Communication Skills - Written and Verbal
  • Provide timely feedback to the company regarding customer service failures and/or customer/provider concerns
  • Knowledge of HIPPA Compliancy and its importance in the insurance industry

  • Perform other related duties as assigned

    Education and Experience

    • High School Diploma; or equivalent. AA in business; or equivalent or business related college courses preferred
    • Must have three to five years of eligibility/data entry experience in a healthcare environment, insurance, and/or account work environment. Experience in the vision insurance industry would be preferred.
    • Intermediate level of MS Excel and Word. Strong technical skills to support key data entry.


      • Accuracy
      • Attention to detail
      • Communication
      • Critical evaluation/thinking
      • Customer/client service focused
      • Prioritization/organization
      • Problem solving/analysis
      • Teamwork
        We take pride in our recruiting process and follow a merit-based employee recruitment practice with extensive screening steps. We will never request money from candidates who seek employment with us and will never ask for any payment as part of the recruitment process.

        We provide equal employment opportunities (EEO) to all associates and applicants for employment without regard to race, color, religious beliefs, sex, gender identity, sexual orientation, age, marital status, national origin, ancestry, physical or mental disability or history of disability, genetic information, status as a protected veteran or disabled veteran, or any other status protected by Federal, state or local law.
        If you are prohibited from working on a government contract, this may disqualify you from consideration for this position.
        Other details
        • Job Family Non Exempt
        • Pay Type Hourly

Keywords: Versant Health, Rancho Cordova , Eligibility Specialist, Other , Rancho Cordova, California

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