Top 271 Eligibility specialist Jobs in Pittsburgh, Pa

Enrollment Specialist I
UPMC —Pittsburgh, PA
- $19.47 - $30.40 an hour
- Full-time
- Microsoft Office
- Leadership
- Communication skills
Housing Solutions Specialist II (Closes 8/3)
Allegheny County Department of Human Services —Pittsburgh, PA
- $60,000 - $65,000 a year
- Full-time
- Hybrid work
- Mid-level
- Office
- Master's degree
Quick Apply
County Children, Youth, and Families Program Specialist 2 (Local Government)
Commonwealth of PA —Pittsburgh, PA
- $85,099.00 - $93,608.90 a year
- Full-time
- Mid-level
- Office
- 3 years
- Work from home
4d
AUTHORIZATION SPECIALIST
CHC Solutions, Inc. —Pittsburgh, PA
- Microsoft Outlook
- Office
- Organizational skills
- AD&D insurance
- Disability insurance
Quick Apply
Order Management Specialist
GE Vernova —Charleroi, PA
- $69,600 - $104,400 a year
- Full-time
- Inventory management
- Pass drug screening
- Mid-level
- Paid parental leave
- Paid holidays
Occupancy Specialist
HACP —Pittsburgh, PA
- Full-time
- Bilingual
- Microsoft Outlook
- Mid-level
Quick Apply
Absence Management Specialist II
UPMC —Pittsburgh, PA
- $29.92 - $51.79 an hour
- Full-time
- Word processing
- Writing skills
- Data analysis skills
4d
Compliance Specialist - CMF
EHDOC —Millvale, PA
- Full-time
- 5 years
- Office
- High school diploma or GED
Quick Apply
Health Specialist EHS
Council Of The Three Rivers American Indian Center, Inc. —Pittsburgh, PA
- $17.77 - $26.78 an hour
- Full-time
- CPR Certification
- Current TB test
- Computer literacy
- Health insurance
- Dental insurance
Quick Apply
Spotting Specialist
Tucker Freight Lines —Aliquippa, PA
- $21 - $23 an hour
- Full-time
- Heavy lifting
- Pass drug screening
- Driver's License
- Disability insurance
- Health insurance
Quick Apply
Pro Services Specialist (Bilingual – English/Spanish Preferred)
Floor and Decor Outlets of America, Inc. —Bethel Park, PA
- From $15 an hour
- 8 hour shift
- Spanish
- High school diploma or GED
- Travel
- Employee stock purchase plan
- Paid holidays
Quick Apply
7d
Reimbursement Specialist
Zeal Specialty Pharmacy —Pittsburgh, PA
- $19.00 - $21.50 an hour
- Full-time
- Customer service
- Mid-level
- High school diploma or GED
- Health insurance
- Dental insurance
Quick Apply
Behavior Specialist - Education
Wesley Family Services —Canonsburg, PA
- $40,000 - $48,000 a year
- Full-time
- Classroom
- HIPAA
- Driver's License
- Paid parental leave
- Paid holidays
Quick Apply
Program Specialist - Pittsburgh
Barber National Institute —Bridgeville, PA
- Extended hours
- CPR Certification
- Mid-level
- Residential
Experienced Tax Professional up to $35/hr
H&R Block —North Versailles, PA
- $19 - $35 an hour
- Temporary
- CPA
- Sales
- 5 years
- Employee stock purchase plan
- Health insurance
Quick Apply
Senior Flooring Design Sales Specialist
Floor and Decor Outlets of America, Inc. —Bethel Park, PA
- From $16.78 an hour
- Computer literacy
- Basic math
- Bachelor's degree
- Employee stock purchase plan
- Paid holidays
Quick Apply
Attendance, Communication, and Engagement Specialist
Commonwealth Charter Academy —Cranberry Township, PA
- Full-time
- Customer service
- Mid-level
- Office
Behavioral Health Absence Specialist
UPMC —Pittsburgh, PA
- $27.89 - $48.21 an hour
- Full-time
- LMFT
- Computer literacy
- Licensed Clinical Social Worker
LIFE Program Specialist
LIFE Pittsburgh —Pittsburgh, PA
- $27 - $33 an hour
- Overtime
- Hybrid work
- Nursing
- Hospital
- Mid-level
Quick Apply
ROOTS Senior Outreach Specialist
City of Pittsburgh —Pittsburgh, PA
- $64,542 a year
- Full-time
- Mid-level
- 3 years
- High school diploma or GED
3d

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Enrollment Specialist I

UPMC -
Pittsburgh, PA

Apply Now

Job Details

Full-time
$19.47 - $30.40 an hour

Qualifications

Microsoft Office

Full Job Description

UPMC Health Plan has an exciting opportunity for an Enrollment Specialist I position in the Medicare SNP Enrollment department. This is a full-time hybrid position based in the Pittsburgh/Erie area. While you'll primarily work remotely, you'll come into the office occasionally depending on departmental needs.

This position has a set rate of $20.70/hr.

The Enrollment Specialist will be responsible for the creation and maintenance of eligibility in the transactional system, responding to both internal and external customer inquiries, and resolving issues to meet or exceed service requirements. To successfully perform the role, an Enrollment Specialist must have a comprehensive understanding of enrollment regulations and complete all duties with strict regard to policies and procedures. Completes all duties with strict regard to policies and procedures set forth by Enrollment Services Manager, Centers for Medicare and Medicaid Services (CMS), Pennsylvania Department of Welfare (DPW), and Pennsylvania Insurance Department (PID). Performs duties related to the processing and maintenance of all member requested transactions, include generation of required letters to ensure enrollment and/or disenrollment processes are completed compliantly. The role also involves direct interaction with internal and external customers to resolve inquiries and concerns including but not limited to outbound phone calls to members.

Responsibilities:

Understanding of varied and detailed enrollment and disenrollment requirements and processing rules based upon the product (HMO, PPO, EPO, SNP, PDP, Select, Supplemental, or National Complimentary) and Individual vs. Employer Group, including, but not limited to, understanding and application of service areas by product.
Maintain employee/insured confidentiality.
Ability to analyze information to make appropriate decisions regarding enrollment/disenrollment, complying with applicable regulations and governance.
Interact with Sales staff to ensure all required date elements for completed application are received and any issues are addressed timely, in accordance with compliance requirements.
Ability to make eligibility determinations based on CMS (Part A/Part B Eligibility), DPW (Medical Assistance Eligibility), and/or PID requirements, in accordance with the application election period guidelines. Ability to accurately identify appropriate election period based upon analysis of beneficiary/member history and regulatory guidance.
Comprehension and application of eligibility regulations to process enrollment transactions and generation of corresponding letters to members. Must keep up to date with new regulations and guidance.
Process all types of enrollment and disenrollment transactions in accordance with company policies and procedures in a timely manner while meeting production and quality goals.
Initiation and generate of appropriate correspondence based on type of transaction processed, includes initiation of outreach requests and written correspondence (letters), as necessary.
Daily clerical responsibilities related to processing and electronic storage of member correspondence.
Identify areas of concern or trends that may compromise client satisfaction or compliance with government regulations.
Support team projects within Enrollment Services; other projects as assigned.

High school graduate or equivalent required, college degree preferred.
Minimum of six months of customer service and/or call center experience.
Ability to interpret and apply complex eligibility regulations as mandated by CMS, DPW, and PID.
Demonstrates good organizational, interpersonal, leadership and communication skills.
Attention to detail is critical to the success of this position, with skills in customer orientation.
Will need to manage multiple tasks and projects.
MS Office/PC skills required.

Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

Apply Now

Refine Your Search

eligibility specialist jobs in pittsburgh, pa

Enrollment Specialist I

Housing Solutions Specialist II (Closes 8/3)

County Children, Youth, and Families Program Specialist 2 (Local Government)

AUTHORIZATION SPECIALIST

Order Management Specialist

Occupancy Specialist

Absence Management Specialist II

Compliance Specialist - CMF

Health Specialist EHS

Spotting Specialist

Pro Services Specialist (Bilingual – English/Spanish Preferred)

Reimbursement Specialist

Behavior Specialist - Education

Program Specialist - Pittsburgh

Experienced Tax Professional up to $35/hr

Senior Flooring Design Sales Specialist

Attendance, Communication, and Engagement Specialist

Behavioral Health Absence Specialist

LIFE Program Specialist

ROOTS Senior Outreach Specialist

I want to receive the latest job alert for eligibility specialist in pittsburgh, pa

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