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Enrollment Eligibility Representative Jobs (NOW HIRING)

VIVA USA INC

Eligibility Representative

Chicago, IL · On-site

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

VIVA USA INC

Eligibility Representative

Chicago, IL · On-site +1

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

Medix

Eligibility Representative

Tujunga, CA · On-site

$20 - $23/hr

Job Summary Our client is seeking an Eligibility Representative to manage patient insurance ... Enrollment dates are 1/1, 4/1, 7/1, and 10/1). * Short Term Disability Insurance. * Term Life ...

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How much do enrollment eligibility representative jobs pay per hour?

As of Jul 26, 2026, the average hourly pay for 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 are some common challenges faced by Enrollment Eligibility Representatives, and how are they addressed?

Enrollment Eligibility Representatives often encounter challenges such as processing high volumes of applications, interpreting complex eligibility criteria, and addressing concerns from applicants who may be frustrated or confused. These challenges are typically addressed through robust training, support from experienced team leads, and use of digital tools that streamline application review. Working closely with colleagues in customer service and compliance helps ensure accurate, timely resolutions. Representatives also develop strong problem-solving and communication skills over time, which can help them manage even the most difficult cases with professionalism.

What are the key skills and qualifications needed to thrive in the Enrollment Eligibility Representative position, and why are they important?

To thrive as an Enrollment Eligibility Representative, you need strong attention to detail, customer service skills, and a solid understanding of eligibility guidelines, often supported by a high school diploma or some college coursework. Experience with enrollment management systems, CRM software, and knowledge of regulatory requirements are typically important. Excellent communication, problem-solving abilities, and patience help representatives manage complex cases and support applicants effectively. These skills ensure accurate eligibility determinations, high-quality customer experiences, and compliance with organizational and industry standards.

What is an Enrollment Eligibility Representative job?

An Enrollment Eligibility Representative is responsible for reviewing and processing applications for healthcare or insurance enrollment. They verify applicant information, ensure eligibility requirements are met, and work with customers to address any discrepancies. This role requires strong attention to detail, knowledge of enrollment policies, and good communication skills. Representatives may also collaborate with internal teams to resolve issues and provide assistance to applicants.

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Enrollment Eligibility Representative jobs near you
Infographic showing various Enrollment Eligibility Representative job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 81% Full Time, 16% Part Time, and 2% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $46,986 per year, or $22.6 per hour.
Eligibility Representative

Eligibility Representative

VIVA USA INC

Chicago, IL • On-site

Contractor

Posted 5 days ago

Job description

Position Overview
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:
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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