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Eligibility Representative Jobs in Arizona (NOW HIRING)

HOPCo

Eligibility Specialist- Full-Time

Phoenix, AZ · On-site

... Reps for the patient's arrival. Maintains proper Appointment Status settings for each visit, as ... Verifies patient demographic information and insurance eligibility including coordination of ...

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Eligibility Representative information

See Arizona salary details

$22.8K

$41.2K

$71.8K

How much do eligibility representative jobs pay per year?

As of Sep 3, 2026, the average yearly pay for eligibility representative in Arizona is $41,207.00, according to ZipRecruiter salary data. Most workers in this role earn between $34,900.00 and $40,100.00 per year, depending on experience, location, and employer.

What is an eligibility representative?

An Eligibility Representative is a professional who helps individuals determine their qualification for various government or private assistance programs, such as Medicaid, SNAP, or unemployment benefits. They review applications, collect and verify documentation, and explain program requirements to applicants. These representatives often work for government agencies, healthcare organizations, or insurance companies, ensuring that clients receive the support they are entitled to. Their role requires strong communication, organizational, and analytical skills to navigate complex eligibility criteria.

What are the key skills and qualifications needed to thrive as an eligibility representative?

To thrive as an Eligibility Representative, you typically need strong knowledge of eligibility programs, attention to detail, and at least a high school diploma or equivalent. Familiarity with case management software, data entry systems, and often knowledge of government regulations or benefits programs is important. Excellent communication, problem-solving skills, and empathy help in effectively assisting clients and resolving complex eligibility issues. These skills ensure accurate processing of applications, compliance with regulations, and positive client experiences.

What are some common challenges eligibility representatives face when verifying client information, and how can they address them?

Eligibility Representatives frequently encounter challenges such as incomplete documentation, discrepancies in client information, and navigating complex eligibility criteria. To address these issues, it's important to maintain strong attention to detail, communicate clearly with clients to obtain missing information, and stay up-to-date on changing regulations and program requirements. Collaborating with team members and utilizing available resources, such as eligibility software and policy manuals, can also help resolve issues efficiently and ensure accurate determinations.

What is the difference between Eligibility Representative vs Claims Processor?

CriteriaEligibility RepresentativeClaims Processor
Required CredentialsHigh school diploma or equivalent; some roles may prefer certifications in healthcare or insuranceHigh school diploma or equivalent; certifications in claims processing are a plus
Work EnvironmentOffice setting, interacting with clients and insurance providersOffice setting, reviewing and processing insurance claims
Employer & Industry UsageHealth insurance companies, healthcare providers, government programsInsurance companies, healthcare organizations, third-party administrators
Common Search & Comparison IntentUnderstanding roles related to insurance eligibility and customer serviceDifferences in claims processing and administrative tasks

Eligibility Representatives focus on verifying patient or client eligibility for insurance coverage, often interacting directly with customers. Claims Processors handle reviewing and processing insurance claims after services are rendered. Both roles require similar credentials and work in healthcare or insurance settings, but their primary functions differ in the insurance process.

What are popular job titles related to Eligibility Representative jobs in Arizona?

For Eligibility Representative jobs in Arizona, the most frequently searched job titles are:

What job categories do people searching Eligibility Representative jobs in Arizona look for?

The top searched job categories for Eligibility Representative jobs in Arizona are:

What cities in Arizona are hiring for Eligibility Representative jobs?

Cities in Arizona with the most Eligibility Representative job openings:

Eligibility Representative jobs near you
Infographic showing various Eligibility Representative job openings in Arizona as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 15% Part Time, and 2% Contract. Highlights an 96% Physical, 2% Hybrid, and 2% Remote job distribution, with an average salary of $41,207 per year, or $19.8 per hour.

Authorization and Eligibility Representative

OrthoArizona

Chandler, AZ • On-site

$16.50 - $21.25/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 6 days ago

OrthoArizona rating

6.5

Company rating: 6.5 out of 10

Based on 31 frontline employees who took The Breakroom Quiz

612th of 898 rated healthcare providers

Job description

Authorization amp; Eligibility Representative
About OrthoArizona:
At OrthoArizona, we are bringing the best together. Our organization was created to help serve ALL orthopedic and podiatry needs throughout the Valley! We have a wide range of orthopedic surgeons and mid-level providers including physical and occupational therapists.
Today we are one of Arizona’s largest privately owned and most comprehensive orthopedic practices with more than 75 locally and nationally renowned providers across 30 locations, in addition to 2 ambulatory surgical centers and in house state of the art MRI capabilities. At OrthoArizona we are committed to best-in-class patient care, being a pioneer in research and technology, and most importantly, rewarding and recognizing our employees.
As an Authorization amp; Eligibility Representative with OrthoArizona, you will get to:
  • Verify insurance coverage for potential new patients, add Ons, and re-verify insurance coverage for existing patients.
  • Navigate through multiple insurance portals or by phone to obtain necessary insurance benefits.
  • Reconciles obtained information within the Practice Management System, EMR, and Phreesia to ensure successful claim processing.
  • Responsible for obtaining all referrals and authorizations for Physical Therapy Patients, as required.
  • Responsible for acting as a liaison between patients, healthcare providers, and insurance carriers to ensure all proper measures are taken and information is collected.
  • Enter any authorization numbers and expiration dates into the Practice Management System, EMR, and Phreesia for proper claim processing.
  • Update pertinent insurance notes in multiple EMR systems for corresponding departments to access.
  • Maintain medical records in accordance with practice policies and procedures.
  • **Using state or federally regulated websites may require personal login credentials.
Minimum Qualifications:
  • Excellent customer / patient service.
  • Knowledge of medical terminology.
  • Working knowledge of computer programs.
  • Excellent written and verbal communication skills.
  • Understand/Perform training on practice management software.
  • Ability to promote favorable facility image with physicians, patients, insurance companies, and general public.
  • Ability to communicate effectively on the telephone.
  • Ability to make decisions and solve problems.
  • Working knowledge of health insurance plans including reading plan requirements.
  • Follow all Standard Operating Procedures.
  • High School diploma or GED.
  • Minimum of 2 years of experience in healthcare administration or related field.
  • Strong organizational and communication skills.
  • Ability to work independently and as part of a team.
  • Ability to meet metric deadlines and stay within goal expectations with little oversight.
  • Knowledge of medical terminology and insurance authorization processes.
Preferred Qualifications:
  • Centricity Software and Phreesia Experience
Full Time Benefits:
  • Robust paid time off package including, sick time, holidays, amp; paid time off!
  • Medical with multiple different plan options.
  • Health Savings account + company contributions.
  • Dental amp; Vision insurance.
  • 401(k)
  • Pet insurance.
  • ID Theft protection amp; Legal assistance.

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