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Eligibility Representative

100% Remote (Within US)

7.0 Months

Full-Time $17-$22/hr

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Posted: May 26, 2026

Ref: KBILER26

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:
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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Competitive Benefits

Your well-being Matters

Health & Future Fully Covered

At VIVA, employee well-being is paramount. Our comprehensive benefits package ensures your health, financial security, and quality of life are always prioritized.

Health Insurance

VIVA provides employees access to a comprehensive group health insurance plan (Medical, Dental, Vision, Basic Life, Term Life, and Accidental Death) through our flexible PPO plan-allowing you the freedom to choose healthcare providers.

401(k) Retirement Planning

Plan securely for your future with automatic payroll deductions into a tax-advantaged 401(k) retirement plan, including employer-matching contributions for eligible employees.

Performance Bonuses & Referrals

Earn performance-based bonuses and generous referral incentives of up to $500 when recommending talented candidates who become part of the VIVA family.

Biweekly Direct Deposit

Enjoy timely and convenient payroll with biweekly direct deposit to your chosen financial institution. Biweekly Direct Deposit

VIVA Perks Program

Access exclusive employee discounts and savings on electronics, travel, groceries, apparel, and more through our dedicated VIVA Perks Program.

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