Eligibility Specialist
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Job Location:
Austin, TX - USA
Monthly Salary:
$ 60000 - 70000
Posted on:
15 hours ago
Vacancies:
1 Vacancy
Job Summary
About Curative
Curative is building the future of health insurance with a first-of-its-kind employer-based plan designed to remove financial barriers and make care truly accessible: one monthly premium with $0 copays and $0 deductibles*. Backed by our recent $150M in Series B funding and valuation at $1.275B Curative is scaling rapidly and investing in AI-powered service deeper member engagement and a smart network designed for todays workforce.
Our north star guides everything we do: healthcare only works when people can actually use it. That belief drives every decision we make: from how we design our plan support our members to how we collaborate as a team.
If you want to do meaningful work with a team that moves fast experiments boldly and cares deeply Curative is the place to do it. Were growing fast and looking for teammates who want to help transform health insurance for the better.
SUMMARY
The Eligibility Specialist is responsible for all administrative processing of Curatives clients new enrollment and ensuring that their routine maintenance eligibility is updated timely and accurately. This role will work with clients directly along with their agent of record. This position is responsible for accurate reporting of all changes for the account management and implementation department.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Process all transaction types such as adds term changes group discrepancies and other eligibility related tasks.
- Review and process all manual and / or EDI enrollment transactions (adds changes terms) received from clients or internal sources in accordance with Certificates of Coverage and Summary Plan Descriptions.
- Produce electronic spreadsheets and /or reports for audit and processing purposes.
- Research and correct escalated billing issues.
- Perform full reconciliations on accounts to confirm that the group is in compliance.
- Meet established processing cycle time standards and production due dates.
- Identify inefficiencies within the established processes and suggest possible solutions to save time reduce risk and increase quality of work.
- Track and Trend enrollment data for CQI
- Be a liaison to Curative overall on industry and market demands to impact process product and tech development along with any process improvements.
- Performs other duties as assigned
QUALIFICATIONS
To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:
- Outstanding organizational time management and follow-up skills.
- Knowledge of processing Electronic Data Interchange (EDI) file updates.
- Knowledge of Healthcare eligibility and billing procedures as well as HIPAA Cobra and ERISA.
- Proficient with Microsoft Office Suite Google Workspace and Adobe
- Experience with CRM software preferably Salesforce
- Ability to communicate effectively and interpret a variety of instructions in a fast-paced environment.
- Excellent organizational and time management skills.
EDUCATION and/or EXPERIENCE
- Bachelors and / or an associate degree plus 3 years administrative expertise or any combination
education and experience that has been achieved and is equivalent to the stated education and required
knowledge.
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- While performing the duties of this Job the employee is regularly required to sit; use hands to handle or feel; talk; and hear.
- Specific vision abilities required by this job include close vision distance vision color vision peripheral vision depth perception and ability to adjust focus.
- The noise level in the work environment is usually: Mild
Perks & Benefits
Curative Health Plan (100% employer-covered medical premiums for you and 50% coverage for dependents on the base plan.)
$0 copays and $0 deductibles (with completion of our Baseline Visit )
Preventive and primary care built in
Mental health support (Rula Televero Two Chairs Recovery Unplugged)
One-on-one care navigation
Chronic condition programs (diabetes weight hypertension)
Maternity and family planning support
24/7/365 Curative Telehealth
Pharmacy benefits
Comprehensive dental and vision coverage
Employer-provided life and disability coverage with additional supplemental options
Flexible spending accounts
Flexible work options: remote and in-person opportunities
Generous PTO policy plus 11 paid annual company holidays
401K for full-time employees
Generous Up to 812 weeks paid parental leave based on role eligibility.
Required Experience:
IC
Key Skills
- Sales Experience
- Crane
- Customer Service
- Communication skills
- Heavy Equipment Operation
- Microsoft Word
- Case Management
- OSHA
- Team Management
- Catheterization
- Microsoft Outlook Calendar
- EHS
About Company
We are looking for an energetic Staff Accountant looking to obtain accelerated learning and experience in a fast-paced, high growth environment. Our health insurance organization is seeking an entry level Staff Accountant. The successful applicant will work on accounts payable, accoun ... View more
