19 Eligibility Jobs

Gainwell Technologies LLC Summary As a Business Analyst at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve a community's most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare's biggest challenges. Here are the details on this position. Your role in our mission Play a critical part in ensuring Gainwell is meeting our clients objectives in important areas. Help coordinate a business analyst team's duties and activities on IT projects and nurture newer team members by providing guidance and support Be a ...

Summary Gainwell Technologies is the leading provider of technology solutions that are vital to the administration and operations of health and human services programs. We are the key player in the Medicaid space with a presence in 51 of the 56 U.S. states and territories with offerings including Medicaid Management Information Systems (MMIS), Fiscal Agent Services, Program Integrity, Care Management, Immunization Registry, and Eligibility Services. We generate over $2 billion in annual revenue, and we've been innovating in the industry for more than 50 years. Powered by more than 14,000 employees, Gainwell solutions support more than 60 million Medicaid beneficiaries nationwide and manage 1...

Gainwell Technologies LLC Gainwell Technologies is the leading provider of technology solutions that are vital to the administration and operations of health and human services programs. We are the key player in the Medicaid space with a presence in 51 of the 56 U.S. states and territories with offerings including Medicaid Management Information Systems (MMIS), Fiscal Agent Services, Program Integrity, Care Management, Immunization Registry, and Eligibility Services. We generate over $2 billion in annual revenue, and we've been innovating in the industry for more than 50 years. Powered by more than 14,000 employees, Gainwell solutions support more than 60 million Medicaid beneficiaries natio...

Gainwell Technologies LLC Gainwell Technologies is the leading provider of technology solutions that are vital to the administration and operations of health and human services programs. We are the key player in the Medicaid space with a presence in 51 of the 56 U.S. states and territories with offerings including Medicaid Management Information Systems (MMIS), Fiscal Agent Services, Program Integrity, Care Management, Immunization Registry, and Eligibility Services. We generate over $2 billion in annual revenue, and we've been innovating in the industry for more than 50 years. Powered by more than 14,000 employees, Gainwell solutions support more than 60 million Medicaid beneficiaries natio...

Gainwell Technologies LLC Summary As a Sr Business Analyst at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve a community's most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare's biggest challenges. Here are the details on this position. Your role in our mission Play a critical part in ensuring Gainwell is meeting our clients objectives in important areas. Help coordinate a business analyst team's duties and activities on IT projects and nurture newer team members by providing guidance and support. B...

Gainwell Technologies LLC Summary As a Sr Business Analyst at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve a community's most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare's biggest challenges. Here are the details on this position. Your role in our mission Play a critical part in ensuring Gainwell is meeting our clients objectives in important areas. Help coordinate a business analyst team's duties and activities on IT projects and nurture newer team members by providing guidance and support Be...

As a Workday Absence Management and Time Tracking Consultant, your primary focus will be on configuring and optimizing the absence and time tracking module within Workday. Your responsibilities will include: - Configuring and supporting Workday Absence Management and Time Off modules - Setting up absence plans, accruals, holiday schedules, and time-off policies - Maintaining rules for absence tracking, eligibility, and balances - Configuring time entry rules, work schedules, time reporting, and time approval processes for the time tracking module - Maintaining configurations for overtime, shift differentials, and break times You will be the owner of the Workday absence and time tracking modu...

Role & responsibilities Handle end-to-end employee benefits administration for US clients (Health, Dental, Vision, Life, Disability plans). Process enrollment, terminations, changes, renewals , 401k Plan and maintain accurate records. Communicate with insurance carriers, brokers, and clients to resolve benefit-related queries. Assist employees with coverage, claim status, eligibility, and policy clarifications. Ensure compliance with HIPAA, ACA, COBRA, ERISA and other US healthcare regulations. Manage escalations and provide solutions within defined SLAs. Maintain updated knowledge of US healthcare reforms, open enrollment processes , and benefit renewals. Prepare reports, benefit summaries,...

The position involves managing medical billing and accounts receivable, insurance credentialing, eligibility verification, claim denials and appeals, patient communication, compliance, documentation, reporting, and analysis. You will be responsible for processing and reviewing medical claims, following up with insurance companies and patients on outstanding balances, and managing insurance credentialing processes. Additionally, you will verify patient insurance coverage, assist patients with understanding their benefits, and investigate and resolve denied claims through appeals. You must ensure compliance with healthcare regulations, maintain accurate billing documentation, and stay updated ...

You will join BeeperMD as an AR/Eligibility and Benefits Specialist in Chandigarh on a full-time, on-site basis. Your primary responsibilities will include managing patient eligibility, verifying benefits, analyzing patient accounts, invoicing, and interacting with patients to address their account-related queries. Alongside these tasks, you will also handle debt collection and ensure the accuracy of financial records. To excel in this role, you must possess strong analytical skills and have prior experience in Denials or Eligibility and Benefits. Effective communication skills, both written and verbal, are essential for this position. You should be capable of working both independently and ...

The Staff Nurse position in Saudi Arabia is looking for qualified candidates to join reputable hospitals in the country. As a Staff Nurse, you will need to have recent clinical experience in specialized hospital departments and a dedication to providing compassionate and high-quality care. To be eligible for this role, you must hold a B.Sc. in Nursing with Apostille certification, have a minimum of 2 years of relevant experience in departments such as Operating Room (OR), Intensive Care Unit (ICU), Neonatal Intensive Care Unit (NICU), and Pediatric Intensive Care Unit (PICU). Additionally, you should not have any employment gaps in the last 6 months, possess a valid Nursing License, and fall...

Job opening at Intellisight India Pvt. Ltd in the field of Eligibility, Authorizations & Referrals (US Healthcare) Role : Eligibility, Authorizations & Referrals in US Healthcare Role & Responsibilities : Processes prior authorizations and referral requests promptly, ensuring they are completed before patient services commence. Researches patient member benefits, coverage limitations, and allowances to secure necessary authorizations and referrals for patient services. Receives and manages referral requests from providers and health plans related to patient visits and procedures. Verifies member eligibility and benefits using health plan provider portals or eligibility services, accurately e...

Huge hiring for Immediate Joiner!!! Role: Eligibility Verification (EVBV) Location: Hyderabad Shift Timings : 5:30 PM to 2:30 AM / 6:30 PM to 3:30 AM Work days: 5 Days (Saturday & Sunday) Both the way cab Role & Responsibilities: ? Responsible for reaching out to the payor to check on the insurance eligibility and the benefits of the patient. ? Addressing the claims to insurance or Self Pay (Patient Attention) based on the eligibility identified. ? Responsible for achieving the defined TAT on deliverables with the agreed Quality benchmark score. ? Responsible for analyzing an account and taking the correct action. ? Ensuring that every action to be taken should be resolution oriented whilst ...

You are a dedicated Senior Process Executive - HC with 1 to 2 years of experience, sought to join our team. Your technical expertise in Order to Cash workflow will be key, working in a hybrid model with night shifts. Travel is not required for this role. Your main responsibility will be ensuring the efficient and accurate processing of orders and related tasks in our healthcare operations. You will execute the Order to Cash workflow with precision and efficiency, ensuring the accurate and timely processing of orders to maintain smooth operations. Collaboration with team members to resolve any discrepancies in Order processing will be essential. Maintaining detailed records of all transaction...

**Immediate Joiners are preferred** Work Location: Hyderabad Role & Responsibilities: : Deliver training sessions on US Healthcare processes including claims, billing, eligibility, and customer service protocols. Proven experience in training with over 1+ years of experience as a Trainer on papers. Facilitate onboarding and nesting programs for new hires in a contact center setup. Collaborate with operations, quality, and client teams to ensure training alignment with business goals. Conduct refresher and upskilling sessions for existing staff based on performance and process updates. Maintain training effectiveness through assessments, feedback, and continuous improvement. Support process t...

The Workday Absence Management and Time Tracking Consultant in this role will focus on configuring and optimizing the absence and time tracking module within Workday. This includes responsibilities such as setting up absence plans, accruals, holiday schedules, time-off policies, and maintaining rules for absence tracking, eligibility, and balances. Additionally, the consultant will support the time tracking module by configuring time entry rules, work schedules, time reporting, time approval processes, and maintaining configurations for overtime, shift differentials, and break times. As the owner of the Workday absence and time tracking module, you will be responsible for designing, solution...

As the Workday Absence Management and Time Tracking Consultant, you will focus on configuring and optimizing the absence and time tracking module within Workday. Your responsibilities will include configuring and supporting Workday Absence Management and Time Off modules, setting up absence plans, accruals, holiday schedules, time-off policies, maintaining rules for absence tracking, eligibility, and balances. Additionally, you will support the time tracking module by configuring time entry rules, work schedules, time reporting, time approval processes, and maintaining configurations for overtime, shift differentials, and break times. You will own the Workday absence and time tracking module...

As an Admission Coordinator based in Mugalivakkam, you will play a crucial role in facilitating the entire admission process for prospective students and their families. Your primary responsibility will be to ensure a seamless experience from the initial inquiry stage to enrollment. Your excellent communication skills in English will be essential in guiding and assisting potential students and parents. You will be required to provide detailed information on various programs, eligibility criteria, scholarships, and financial aid options available. Collaboration with marketing teams will be necessary to develop and execute effective recruitment strategies, including outreach programs to attrac...

Shift Times : US Shits Location : Navi Mumbai Role & responsibilities Overall responsibility for ensuring eligibility services meet or exceed client and operational KPIs Serve as a resource/SME for team members and projects on all aspects of Eligibility including, but not limited to COBRA, Dependent Eligibility Audits, Electronic Eligibility, automated enrollment, Real Time Eligibility, ID cards, in addition to manual enrollment. Develop, maintain and manage operational dashboards that include KPIs and staff resource plans Manage and prioritize department, team and individual plans actions with a client centric and forward thinking perspective Use process methodologies, like root cause analy...