Eligibility Service Representative jobs in United States
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MagnaCare ยท 14 hours ago

Eligibility Service Representative

positionUnited States
timeFull-time
remoteRemote
seniorityNew Grad, Entry Level
money$43K/yr - $50K/yr

Brighton Health Plan Solutions (BHPS) is seeking an Eligibility Service Representative (ESR) who are experienced in understanding eligibility and communicating through various multi-channel features. The ESR will assist in issue resolution related to eligibility, coverage changes, and support the Eligibility & Benefits team.

Health Care

Responsibilities

The ESR will be responsible for receiving and resolving caregiver inquiries
Works with the Benefits Enrollment team to review and resolve any eligibility, hours or co-premium issues including follow-up outreach to caregivers Listen attentively to customer needs and concerns; demonstrate empathy and offer solutions
Demonstrate strong customer service skills, attention to detail, research & analyzation and issue resolution
Clarify customer requirements; probe for and confirm understanding of requirements or problem
Agent will be responsible for managing caregiver requests within required turnaround time including conducting outreach to internal partners, engaging the support of the Team Leader and Supervisor as necessary
Communicate effectively with individuals/teams to ensure high quality and timely expedition of customer requests
Participate in activities designed to improve customer satisfaction and business performance
Use decision-support tools to answer questions, where needed
Ability to use critical thinking to solve complex problems and identify when to escalate to the appropriate department
Performs call center functions including handling inbound calls and support projects as directed by the management
Maintain broad knowledge of client requirements, procedures and key contacts
Support projects and other departments in completing tasks when directed by management

Qualification

High-volume enrollment experienceBilingual (Russian/English)Bilingual (Korean/English)Call center experienceHIPAA knowledgeMicrosoft OfficeInvestigative skillsCustomer service skillsTime management skillsEffective communication

Required

Bilingual in Russian/English or Korean/English
Flexible availability for alternate schedules/hours, including shifts between 11AM and 9PM EST, Monday through Friday, with training from 9AM to 6PM
Experience in high-volume enrollment and eligibility transactions, premium billing, and collections
Knowledge of labor and commercial carrier enrollment procedures
Prior high-volume call center experience
General knowledge of HIPAA Confidentiality
High School diploma or GED
Remote work capability with internet access
Basic computer skills, including Microsoft Office (Word, Excel, Access, PowerPoint, Outlook)
Strong investigative and time management skills
Courteous and customer-service oriented
Detail-oriented and dependable
Effective communication through multiple channels (email, chat, voice)

Preferred

Preferred experience in enrollment/eligibility roles, especially in commercial and labor plans
Previous multi-channel experience (voice, email, chat) is a plus
Some college or business school education is advantageous

Company

MagnaCare

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MagnaCare, a division of Brighton Health Plan Solutions, has been a leading and trusted Third Party Administrator for over 30 years.
dateFounded in 1990
location
New York, New York, USA
people-size201-500 employees
web-link
http://www.magnacare.com

Funding

Current Stage
Growth Stage
Total Funding
unknown
2014-01-20Acquired

Recent News

TecHR
Remote Work Is Transforming Healthcare Priorities, Especially for Younger Employees, New MagnaCare Survey Finds
2025-05-17
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