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Associate Enrollment Eligibility Representative Jobs

VIVA USA INC

Eligibility Representative

Chicago, IL · On-site +1

The Eligibility Representative is responsible for performing analytical and administrative ... Key Responsibilities Process and maintain eligibility and enrollment transactions, including ...

Mindlance

Eligibility Representative

This is set up for B-Flex time entry not SPARK remote Eligibility Representative Delivers ... Knowledge of Medicare Advantage Enrollment and Eligibility. Familiar with Medicare Part A, Part B ...

VIVA

Eligibility Representative

The Eligibility Representative is responsible for performing analytical and administrative ... Key Responsibilities Process and maintain eligibility and enrollment transactions, including ...

TeamHealth

Eligibility Representative

Akron, OH · On-site

Eligibility Representative | TeamHealth Eligibility Representative Akron, OH Overview This position is responsible working denial reports & correcting/refiling claims based on denial or rejection ...

Strive Health

Associate, Enrollment

Denver, CO

$22.12 - $25/hr

Depending on the patient's eligibility, this role will also be collecting sensitive patient ... the Enrollment Associate. By establishing an empathetic connection with our patients, this ...

Medix

Eligibility Representative

Sarasota, FL · On-site

$19.10 - $23.85/hr

The actual posting represents a position at one of our clients. Job Summary Our client is seeking ... Guide individuals through eligibility and enrollment processes for government-sponsored and ...

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Associate Enrollment Eligibility Representative information

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How much do associate enrollment eligibility representative jobs pay per hour?

As of Jul 6, 2026, the average hourly pay for associate enrollment eligibility representative in the United States is $22.59, according to ZipRecruiter salary data. Most workers in this role earn between $18.03 and $25.72 per hour, depending on experience, location, and employer.

What is the difference between Associate Enrollment Eligibility Representative vs Customer Service Representative?

AspectAssociate Enrollment Eligibility RepresentativeCustomer Service Representative
CredentialsHigh school diploma; some roles may require certifications in healthcare or insuranceHigh school diploma or equivalent; customer service training often preferred
Work EnvironmentHealthcare or insurance offices, call centersRetail, call centers, service centers
Employer & IndustryHealth insurance companies, healthcare providersVarious industries including retail, telecom, finance
Job FocusVerifying eligibility, processing enrollments, assisting with benefitsHandling customer inquiries, resolving issues, providing product info

The Associate Enrollment Eligibility Representative primarily focuses on verifying insurance eligibility and processing enrollments within healthcare or insurance settings. In contrast, Customer Service Representatives handle a broader range of customer inquiries across various industries. While both roles require strong communication skills, the Associate Enrollment Eligibility Representative specializes in benefits and eligibility, often requiring healthcare-related knowledge and certifications.

What are the key skills and qualifications needed to thrive as an Associate Enrollment Eligibility Representative, and why are they important?

To thrive as an Associate Enrollment Eligibility Representative, you need strong attention to detail, knowledge of healthcare or insurance processes, and typically a high school diploma or equivalent. Familiarity with enrollment management software, claims processing systems, and Microsoft Office Suite is commonly required. Excellent communication, problem-solving, and customer service skills help you effectively assist clients and resolve eligibility issues. These skills ensure accurate enrollment processing, compliance with regulations, and a positive experience for clients and members.

What are some common challenges faced by Associate Enrollment Eligibility Representatives, and how can they be addressed?

Associate Enrollment Eligibility Representatives often encounter challenges such as managing high volumes of enrollment applications, ensuring data accuracy, and staying current with frequently changing health plan regulations. To address these challenges, it's essential to develop strong organizational skills, be detail-oriented, and proactively seek clarification when guidelines change. Many teams offer ongoing training and encourage collaboration, so taking advantage of available resources and open communication with colleagues can help overcome these hurdles effectively.

What does an Associate Enrollment Eligibility Representative do?

An Associate Enrollment Eligibility Representative is responsible for reviewing and processing enrollment applications for health insurance or other benefit programs. They verify applicants' information, ensure eligibility requirements are met, and resolve any discrepancies or issues that arise during the enrollment process. These professionals often communicate with applicants, employers, and insurance providers to obtain necessary documentation and provide updates on application status. Their work ensures that individuals receive the correct benefits coverage in a timely manner.
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Associate Enrollment Eligibility Representative jobs near you
Eligibility Representative

Eligibility Representative

VIVA USA INC

Chicago, IL • On-site, Remote

Contractor

Posted 12 days ago

Job description

The Eligibility Representative is responsible for performing analytical and administrative functions to support Medicare enrollment and eligibility processes. This position is data-driven and transactional in nature, with a strong focus on accuracy, compliance, and Medicare requirements rather than customer-facing activities.
Key Responsibilities
Process and maintain eligibility and enrollment transactions, including updates, corrections, and reconciliations of member data
Review and analyze eligibility reports to identify discrepancies and ensure accurate resolution
Implement and maintain data across automated systems, direct connections, and manual workflows
Verify eligibility and ensure compliance with Medicare guidelines and regulatory requirements
Partner with internal teams (e.g., systems, operations) to investigate and resolve data or processing errors
Perform detailed data entry and validation tasks with a high level of accuracy and timeliness
Monitor transaction outputs to ensure completeness and adherence to established standards
Important Role Clarification
This role is not primarily customer service-based and does not focus on call handling. This role is customer focus , not customer service . We don't speak to members at all really.
Responsibilities center on processing enrollment transactions and eligibility data, which require strong analytical skills and attention to detail
Verifying eligibility and processing enrollment applications/transactions are distinct functions, with this role emphasizing transaction processing and data integrity
Required Qualifications
Working knowledge of Medicare Advantage enrollment and eligibility (Part A, Part B, and Part C)
Strong analytical and problem-solving skills with a data-focused mindset
High attention to detail and ability to manage large volumes of transactional work
Proficiency in Microsoft Office Suite (especially Excel)
Ability to work independently with minimal supervision
Strong written communication skills for internal collaboration
Preferred Qualifications
1+ year of experience in healthcare insurance
1+ year of experience in enrollment and eligibility processing (Medicare Advantage preferred)
Prior experience with data entry, enrollment systems, and transaction processing
Notes:
This role is configured for B-Flex time entry (not SPARK) and is fully remote.
VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

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