Responsible for creation and maintenance of member and provider eligibility records. Research and reconcile authorization data to ensure accuracy. Perform manual entry of authorizations into various client systems. Comfortable with high degree of contact with case managers, client contacts, and providers.

• Evaluates data and determines what process is required for specific systems and accounts.
• Processes member enrollment and change of coverage requests. 
• Verifies provider contractual status.
• Corresponds with contacts regarding member and provider data.
• Resolves problems with automated transmission of authorizations. 
• Responsible for timely and accurate keying of authorizations in client systems.

Other Job Requirements

Responsibilities

Minimum of 1 year customer service, claims, or general office experience.
Proficient with MS Office software.
Ability to type 60 WPM.
Strong ten key user.
Results and solution oriented; not afraid to ask questions

General Job Information

Title

Eligibility Processor I

Grade

17

Work Experience - Required

Claims, Customer Service

Work Experience - Preferred

Education - Required

GED, High School

Education - Preferred

License and Certifications - Required

License and Certifications - Preferred

Salary Range

Salary Minimum:

$31,175

Salary Maximum:

$46,765

This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.