Operations Specialist - Eligibility

Overview : The incumbent will be responsible for supporting the administrative components and processes of the eligibility department for all lines of business supported by Banner Plan Administration. Incumbent is considered the primary eligibility resolution specialist for internal and external clients. Responsibilities will also include auditing and processing of support files, handling special projects, updating and changes in the system. This position will develop and maintain proper record keeping of system support files relating to eligibility and enrollment. Also responsible for developing and creating reports necessary to track and monitor workflow.

Qualifications :

College degree preferred or equivalent experience with a minimum of two years experience in the eligibility/enrollment processes in an automated environment. Should have an understanding of Crystal reporting, Access, SQL server, Visual Basic or Microsoft applications and have the ability to learn program data retrieval utilities. The incumbent is expected to know support file maintenance and revision. Must be able to track and analyze statistical data. Previous eligibility and enrollment experience in a Medical/Dental plan is recommended with a working knowledge of Medicare, Self-funded, and/or commercial insurance plans are required. Strong oral and written communication skills. Familiarity with computers and reports that can be generated from the Impact Claims system, Crystal, and Sequel Server is also required.
Banner Health employees are expected to adhere to Banner's service standards and organizational values in all their interactions with Banner patients, customers, and fellow employees.