Eligibility Processor I (Temp)

Job Description

The Eligibility Processor I is an entry-level position responsible for adding/changing /terminating members manually in Prospect’s core system (IDX). After on-the-job training, this position is expected to take incoming phone calls for eligibility inquiries from providers and internal departments, check health plan websites and portals for eligibility verification, modify eligibility postings in IDX, and work assigned accounts to resolution. **

Responsibilities**

• Take incoming phone calls from providers and internal departments to resolve eligibility inquiries.
• Manually update IDX with changes, additions, terminations to member eligibility and resolve assigned accounts as directed by management. Escalate issues to management as needed.
• Actively participate in supporting special projects as assigned by management.

Qualifications

Minimum Education: Required: High School Diploma or equivalent. **

Minimum Experience: Experience operating PC-based software programs.

Req. Certification/Licensure: NONE

About Us**

With approximately 9,000 physicians to serve our 260,000 members, Prospect Medical Systems is proud to be among the most innovative medical systems in California, Texas and Rhode Island. Our extensive care services range from primary care and specialty physician services to acute care hospital and skilled nursing facilities to behavioral health and wellness services. Each of our Independent Physician Associations (IPAs) and networks support the use of advanced diagnostic and treatment tools to provide our members with convenient access to state-of-the-art healthcare. For 25+ years, Prospect Medical has been focused on our mission of supporting independent physicians where, through risk arrangements, we work closely together with health plans, facilities and healthcare physicians for the benefit of every person who comes to us for care. We provide quality healthcare services that are designed to offer our patients highly coordinated, personalized care and that help them live healthier lives. Prospect Medical Systems manages highly successful IPAs by leveraging our best-practices, results-driven administrative services to manage patients under risk arrangements with health plans/CMS.