Eligibility Reporting Specialist Job at Versant Health

Versant Health Remote

Who are we?

Versant Health is one of the nation’s leading administrators of managed vision care, serving millions of our clients’ members nationwide. We are driven by our mission to help members enjoy the wonders of sight through healthy eyes and vision.

As a Versant Health associate, you can enjoy a comprehensive Total Rewards package, which includes health and dental insurance, tuition reimbursement, 401(k) with company match, pet insurance, no-cost-to-you vision insurance for you and your qualified dependents. We are also invested in your success. There are many opportunities for advancement and development throughout all stages of your career with us.

See how you can make a difference with the support of strong leadership and a team environment.

See Everything, Be Anything™.

What are we looking for?
The Eligibility Reporting Specialist (ERS) is responsible for eligibility error reports for groups that submit information via a variety of acceptable EDI transmissions. The ERS will manually correct any items from the exception report after the data is loaded into the HSP system and create and deliver error reports to our Trading Partners for review. In addition, the ERS will work with Trading Partners and the EDI Specialists to resolve errors and manually correct records in HSP at the direction of the Trading Partners

Where you will have an impact.
  • Work EDI load reports and create resulting error reports to Trading Partners within industry standard guidelines.
  • Weekly productivity reporting is required
  • Update member records in HSP with accuracy and attention to detail in order to maintain fidelity of member data for all Trading Partners
  • Work with EDI Specialists and Eligibility Manager on escalated EDI errors to achieve resolution of persistent EDI errors for all Trading Partners
  • Demonstrate proficiency and accuracy in Data Entry Skills
  • Process emails, phone calls, faxes and other support communications in a timely and professional manner. Record keeping for audit trail is essential
  • Assist with implementation of new groups as assigned by Eligibility Manager or EDI implementation team members
  • Assist with implementation of EDI changes for existing groups
  • Partner with Client Management and the EDI team to meet and exceed customer’s service expectations
  • Provide excellent customer service and handle all customers in a professional and courteous manner
  • Good Communication Skills - Written and Verbal
  • Provide timely feedback to the company regarding customer service failures and/or customer/provider concerns
  • Knowledge of HIPPA Compliancy and its importance in the insurance industry
  • Other duties as assigned
What’s necessary to do the job?
  • High School Diploma; or equivalent. AA in business; or equivalent or business-related college courses preferred
  • Must have three to five years of eligibility/data entry experience in a healthcare environment, insurance, and/or account work environment. Experience in the vision insurance industry would be preferred.
  • Intermediate level of MS Excel and Word. Strong technical skills to support key data entry.
HIPAA & Security Requirements
All Associates must comply with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI) as described in the Notice of Privacy Practices and HIPAA Privacy Policies and Procedures. As a component of job roles and responsibilities, Associates may have access to covered information, cardholder data or other confidential customer information which must be protected at all times. As a result, Associates must explicitly adhere to all data security guidelines established within the Company’s Privacy & Security Training Program.

Versant Health will never request money from candidates who seek employment with us and will never ask for any payment as part of the recruitment process.

Versant Health is a proud Equal Employment Opportunity and Affirmative Action employer dedicated to attracting, retaining, and developing a diverse and inclusive workforce. All qualified applicants will receive consideration for employment at Versant Health without regards to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, national origin, marital or domestic/civil partnership status, genetic information, citizenship status, uniformed service member or veteran status, or any other characteristic protected by law.

The wage range for applicants for this position is [$35,360.00 to $ 41,600.00].
All incentives and benefits are subject to the applicable plan terms.


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