Welcome page

Team Leader Eligibility CCH, Insurance Services

Requisition ID
2024-39425
Category
Other
Shift Type
Full-Time
Shift
8 Hour
Shift Schedule
Days
Facility
Community Medical Centers - Corporate Offices (CMC)
Location
US-CA-Fresno
Posted Date
4/29/2024
Min
USD $27.93/Hr.
Max
USD $39.94/Hr.

Overview

*All positions are located in Fresno/Clovis CA*

At Community Health System, we know that our ability to provide the highest level of care begins with our incredible staff. From unique supplemental and base benefits, to well-being resources, we are here to support you in every stage of life, and your career!

Community Health System is the region’s largest healthcare provider and includes three divisions: Community Medical Centers hospitals, Community Care Health and Community Provider Network. These three pillars of healthcare – hospitals, health insurance and physicians – work best when they work together. 

Opportunities for you!

  • Join a Forbes Top 10 CA Employer!
  • Direct impact on quality patient care
  • Tuition reimbursement, education programs, and scholarships
  • Vacation time starts building on Day 1, and builds with your seniority
  • 403(b) retirement plan with up to 8% matching contributions 
  • Free parking and electric charging
  • Great food options with on-demand ordering

Your Career at Community | Opportunity. Challenge. Growth.

Responsibilities

The Team Leader of Eligibility is responsible for ensuring Community Care Health (CCH) membership is loaded accurately under the appropriate benefit plan and works directly with its delegated vendor to ensure proper oversight and troubleshooting. This incumbent must have great attention to detail and the ability to problem solve.

 
Accountabilities 
  • Assist delegated entity with auditing eligibility files.
  • Serve as the subject matter expert regarding adding, updating, and terminating member eligibility in the claims system.
  • Work with clients, vendors, providers and internal staff to verify insurance coverage for all members.
  • Perform comprehensive research in multiple systems and files to verify accurate member eligibility.
  • Participate in special projects and provide ad hoc analytical eligibility support as needed.
  • Utilize eligibility knowledge and available resources to troubleshoot and resolve complex enrollment situations and provide accurate information.
  • Assist with training new Eligibility staff.
  • Work with human resources contacts and plan sponsors for urgent eligibility updates and open enrollment.

Qualifications

Education
• High School Diploma, High School Equivalency (HSE) or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate required
• Associate's Degree preferred
 
Experience
• 2 years of health insurance, eligibility, or related experience required
• Background in system testing and troubleshooting preferred
• Experience with 834 files preferred

Disclaimers

• Pay ranges listed are an estimate and subject to change.
• If any bonuses are noted, they are only applicable to external hires meeting criteria.

Options

Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
Share on your newsfeed