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Eligibility Specialist (IPA Network Operations) at AltaMed Health Services Corporation

Remote: 
Hybrid
Contract: 
Full time
Salary: 
46 - 54K yearly
Experience: 
Mid-level (2-5 years)
Work from: 
Montebello (US)

Offer summary

Qualifications:

High School Diploma or equivalent required, 4 years' experience in Health Plan Eligibility Data Processing, 3 years' experience in Health Plan Eligibility Data Verification, Experience with EZCAP and EZNET preferred.

Key responsabilities:

  • Ensure timely processing of eligibility data
  • Reconcile member data discrepancy reports
  • Assist with claims and authorization queues
  • Handle Eligibility phone queues as needed
AltaMed Health Services Corporation logo
AltaMed Health Services Corporation Health, Sport, Wellness & Fitness Large https://www.AltaMed.org/
1001 - 5000 Employees
About AltaMed Health Services Corporation
AltaMed is one of the nation’s largest community health networks. For more than 45 years, we have provided care to patients in the diverse neighborhoods of Los Angeles and Orange counties. For health care professionals committed to their patients, communities and careers, AltaMed is an excellent opportunity to pursue professional goals with pride and distinction. AltaMed is a non-profit organization, focused on the needs of our patients and the well-being of our communities. Our commitment to community health compels us to look beyond the walls of our offices and clinics and see not just patients, but new possibilities for community wellness. We have many employees who joined us because their families were AltaMed patients and experienced firsthand that our patients are at the center of all we do. This approach is helping us meet our ambitious goals. We are continually accredited by The Joint Commission (JCAHO), an organization that ensures quality standards in U.S. medical facilities. We’re the first community health network in the nation to have been designated as a Primary Care Medical Home (PCMH). We’re extremely proud of our achievements in patient satisfaction, with our highest scores accomplished during our period of greatest growth. We’ve expanded to 46 Southern California locations, offering primary medical, dental and senior care. We’re active in community outreach and education, and staffed by dedicated professionals committed to patient care. Continuously looking for ways to do more for more people, AltaMed is leading the industry in bringing new people into our nation's health care system as the top enroller for Covered California. As we continue to grow, we remain at the forefront of evolving health care systems, serving patients with comprehensive care throughout their entire lives. And we will build on our reputation as a rewarding long-term decision for both patients and professionals who believe that quality health care is everyone’s right.
See more AltaMed Health Services Corporation offers

Job description

Grow Healthy

If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day.

Job Overview

The Eligibility Specialist- IPA Operations is primarily responsible for ensuring the timely inload, processing and reconciliation of the Monthly. Bi-Monthly, Weekly, Daily Health Plan Eligibility Data files received from AltaMed contracted health plans. This position also includes reconciliation of member data discrepancy reports, working on claims and authorization queues and assisting with the Eligibility phone queues as required.

Minimum Requirements:
1.    High School Diploma or equivalent required.
2.    Minimum of 4 years’ experience of Health Plan Eligibility Data Inload Processing and Reconciliation.
3.    Minimum 3 years’ experience of Health Plan Eligibility Data Verification.
4.    EZCAP, EZNET, Eligibility Manager and Datatug Program experience preferred but not required.

Compensation

$24.00 - $28.15 hourly

Compensation Disclaimer

Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives.

Benefits & Career Development

  • Medical, Dental and Vision insurance
  • 403(b) Retirement savings plans with employer matching contributions
  • Flexible Spending Accounts
  • Commuter Flexible Spending
  • Career Advancement & Development opportunities
  • Paid Time Off & Holidays
  • Paid CME Days 
  • Malpractice insurance and tail coverage
  • Tuition Reimbursement Program
  • Corporate Employee Discounts
  • Employee Referral Bonus Program
  • Pet Care Insurance

Job Advertisement & Application Compliance Statement

AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.

Required profile

Experience

Level of experience: Mid-level (2-5 years)
Industry :
Health, Sport, Wellness & Fitness
Spoken language(s):
Check out the description to know which languages are mandatory.

Hard Skills

EPANETEndcapDatagram

Other Skills

  • Analytical Thinking
  • Verbal Communication Skills
Are you interested?

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