1-3 years of experience
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Employment Type:
Full time
Job Category:
Health Care Provider
Eligibility Rep I-Ops (Woodland Hills)
Health Net, Inc. | Woodland Hills, California
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Job Description

Job Summary

  • Processes and maintains eligibility information for routine individual and/or employer groups under direct supervision
  • Essential Duties & Responsibilities

  • Demonstrates regular, reliable and predictable attendance.
  • Maintains accurate eligibility records for assigned line of business. Enters system eligibility data on a daily basis, including new enrollees, changes, and cancellations.
  • Conducts periodic audits of group eligibility data.
  • Reconciles group eligibility report to monthly statements.
  • Responds to all written and telephone eligibility inquires from individuals or assigned employer groups.
  • Researches information on subscribers to resolve problems and disputes.
  • Maintains quality and production standards as outlined by the department.
  • Assists with special projects.
  • Education

  • High School Diploma or equivalent required
  • Certification/Licensure Required

  • N/A
  • Government Clearance & US Citizenship Requirement


    Experience Required

  • One year general work experience required
  • OR
  • Any combination of academic education, professional training or work experience, which demonstrates the ability to perform the duties of the position.
  • Knowledge, Skills & Abilities

  • Ability to operate PC-based software programs required
  • Excellent written and oral communication skills required
  • Ability to type 40 wpm and operate 10-key by touch required
  • Demonstrated problem solving skills
  • Working Conditions

    • The following section describes the general physical requirements for this position. Please note that constant refers to more than 81% of time; significant refers to 40-80%; and ?moderate? refers to 20-40% of the time.
    • Operates personal computers, printers, facsimile, telephones, copy machines and other commonly used office accessories/equipment.
    • Exposed to confidential information and expected to maintain confidentiality at all times; must adhere to HIPAA rules and regulations.
    • May be required to work outside of normally scheduled hours as mandated by the client, project and/or workload (e.g. evenings, weekends, and/or holidays).
    • May be required to maintain established work pace, meet deadlines; may have last minute urgent requests.
    • Physical activity may include: twisting, reaching, kneeling, bending, stooping, squatting, crawling, grasping, grabbing, pushing, pulling, repetitive motion, climbing, etc.
    • Required to have visual acuity to determine the accuracy, neatness, and thoroughness of the work assigned.
    • Required to have hearing ability to receive detailed information through oral communication.
    • Required to have speaking ability to express or exchange ideas.
    • Constant concentration may be required on various subjects by listening, reading and thinking clearly.
    • Constant interaction with others may be required. May need to listen, think, and speak in order to interact with others. Business interactions and behavior between coworkers and/or external customers are required. This may require face-to-face or telephone interactions.
    • Constant thinking at work may include listening, learning, analyzing, evaluating, and the ability to interpret what is seen and/or heard, or to link information from one issue to the next.
    • Constant computer usage including typing and/or eye strain.
    • Moderate repetitive arm, wrist, hand and finger motions  making repetitive movements (e.g. key boarding, filing, data entry).
    • Constant phone usage; headsets may be required.
    • Significant amount of time spent working in a loud office environment with frequent interruptions/distractions.
    • Constant sedentary work (desk bound or seated).
    • Constant reading is required via computer screen and/or bound printed materials.


    DISCLAIMER: The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this job. They are not intended to be construed as an exhaustive list of responsibilities, duties and skills required of personnel so classified.


    Health Net and its subsidiaries are an Equal Opportunity/Affirmative Action Employer - Minorities/Females/Veterans/Disability



    About Health Net, Inc.

    Health Net, Inc. (Health Net) is an integrated managed care organization that delivers managed healthcare services through health plans and government-sponsored, managed-care plans. The Company operates and conducts its businesses through its subsidiaries. Health Net's health plans and government contracts subsidiaries provide health benefits through its health maintenance organizations (HMOs), insured preferred provider organizations (PPOs) and point-of-service (POS) plans to approximately 6.7 million individuals across the country through group, individual, Medicare, (including the Medicare prescription drug benefit commonly referred to as Part D), Medicaid, TRICARE and Veterans Affairs programs. The Company operates within two segments: Health Plan Services and Government Contracts. (Source: 10-K)

    This company profile was created by AfterCollege and is about Health Net, Inc.. This page is not endorsed by or affiliated with Health Net, Inc.. For questions regarding company profiles, please email: care@aftercollege.com.