Job description

Eligibility Coordinator

About SCAN

SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation’s leading not-for-profit Medicare Advantage plans, serving more than 270,000 members in California, Arizona, and Nevada. SCAN has been a mission-driven organization dedicated to keeping seniors healthy and independent for more than 40 years and is known throughout the healthcare industry and nationally as a leading expert in senior healthcare. SCAN employees are a group of talented, passionate professionals who are committed to supporting older adults on their aging journey, while also innovating healthcare for seniors everywhere. Employees are provided in-depth training and access to state-of-the-art tools necessary to do their jobs, as well as development and growth opportunities. SCAN takes great pride in recognizing our team members as experts in their fields and rewarding them for their efforts. If you are interested in becoming part of an organization that is innovating senior healthcare visit www.thescangroup.org, www.scanhealthplan.com, or follow us on LinkedIn, Facebook, and Twitter.

The job

To maintain the SCAN Health Plan core eligibility system by reconciling, entering, correcting, and deleting member information.

You will

Enters member data by inputting alphabetic and numeric information into IKA system according to screen format including benefit assignment, group affiliation, and provider selection, billing information, revenue codes and appropriate cross references.

Verifies eligibility for enrollment using state and Federal websites.

Provides excellent customer services by making a high volume of outbound calls to members to clarify, obtain, and or confirm information needed to successfully complete member’s enrollment request.

Ensures accurate and timely delivery of incoming and outgoing communications by processing internal and external mail (standard or electronic) upon receipt and facilitating delivery to the appropriate recipient. Researches mail that is returned as undeliverable, and processes in accordance with regulatory guidance and internal policy and procedures.

Complies with HIPAA by securing protected information in accordance with regulatory guidance from common areas such as printers and fax machines and delivering to the appropriate person/location throughout the business day, and ensuring that recycle bins are emptied and the materials placed in secured recycle stations daily

Ensures regulatory compliance by following departmental desktops, policies and procedures, by adhering to state and Federal regulations and requirements.

Contributes to the department efficiency by managing the materials and fulfillment processes (for internal/external customers and department staff). Make copies, send faxes or other standard/electronic communications, collate materials, and deliver/pick up items, as needed.

Supports department compliance by maintaining logs for various tasks, and communicating findings to management.

Assists in other department processes and functions, as assigned.

Contributes to team effort by accomplishing related results as needed.

Your qualifications

Required: High school degree or GED required

1 year of clerical experience.

Experience in Medicare managed care health plan, particularly working with IKA or other healthcare systems is preferred.

Covid-19 Vaccination Policy

To ensure a healthy and safe work environment, if you are selected for this position, your job offer with SCAN Health will be contingent upon being fully vaccinated and providing proof of your COVID-19 vaccine within 3 days after your start date. Generally, you are considered fully vaccinated 14 days after receiving the last dose, as recommended by the manufacturer, of a vaccine that has been authorized by the FDA for use in the United States, including vaccinations that have been approved pursuant to an Emergency Use Authorization. If fully vaccinated outside of the United States, the vaccination must be listed for emergency use by the World Health Organization (WHO). If you cannot receive the vaccine because of a disability/medical reason or sincerely-held religious belief, you may request an accommodation to this requirement by contacting COVID-19 Vaccination Policy. Learn more about the COVID-19 vaccination here - https://www.cdc.gov/coronavirus/2019-ncov/vaccines/index.html

We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!

At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.

SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required. #LI-JR1

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)