Eligibility Analyst - Remote

Overview

The Eligibility Analyst is responsible for representing commercial or government programs' eligibility and acts as a subject matter expert for department projects, run functions, and escalated client issues.

In Short

• Responsible for eligibility processes for new and existing clients.
• Monitors eligibility mailbox and assists with business requirements.
• Acts as primary contact for clients and resolves escalated issues.
• Implements improvements for existing eligibility processes.
• May manage Medicaid subrogation activities.
• Participates in peak season planning and execution.
• Mentors and trains Eligibility Specialists.
• Conducts User Acceptance Testing.
• Works collaboratively in a team-based environment.
• Ensures compliance with security responsibilities and legal requirements.

Requirements

• Bachelor's degree in IT, Business, Liberal Arts, Science or related field.
• 2 years of experience in healthcare, PBM, eligibility, or claims processing.
• Strong oral and written communication skills.
• Strong organizational and time management skills.
• Problem-solving skills with attention to detail.
• Ability to work independently and implement defined objectives.
• Must be eligible to work in the United States without sponsorship.
• Previous PBM experience is preferred.
• Experience with Microsoft Excel is preferred.

Benefits

• Purpose-driven career in pharmacy solutions.
• Equal opportunity and affirmative action employer.
• Diverse and inclusive work environment.
• Reasonable accommodations for applicants with disabilities.
• Tobacco-Free Workplace.