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Salary and Benefits

Eligibility Specialist
$38K-$47K / yr. (est.)
$39K
$43,039 / year
$47K
Average base salary
The salary information provided is based on data collected from various reliable sources and may vary depending on individual qualifications and other factors.

About Eligibility Specialist

What does an Eligibility Specialist do?

As Eligibility Specialists, we are responsible for making hiring decisions based on merit. Recruitment, hiring, training, and job assignments are made without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, or any other protected classification. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including for fair chance initiatives for hiring ordinance. Additionally, we devise reports to the director of operations and determine applicant eligibility for third-party reimbursement, process data for new individuals, and ensure proper coding for insurance billing.

Core tasks:

  • determine and provide initial short-term disability eligibility evaluation
  • systematic initiation of new claims in support of various product types utilizing the appropriate claim adjudication system
  • perform a policy coverage search to determine claim filing eligibility and process based on standard and customized policy instructions
  • manage pending and completed prior to assignment to the corresponding claims organization
  • identify trends, issues and innovative ideas and partner in solutions

Insights

How Many Years of Experience Do Professionals Need Before Becoming Eligibility Specialist?
On average, people work 5-7 years in other positions prior to becoming a Eligibility Specialist.
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Eligibility SpecialistSeattle, WA - 11 months ago
😀 This is ridiculous, it's just another hurdle to prevent skilled individuals from entering the field. Experience should count, but it shouldn't be compulsory!
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Eligibility SpecialistNew York City, NY - 11 months ago
As someone who worked in other roles before transitioning to this position, I believe that having experience in different areas helps in becoming a well-rounded Eligibility Specialist.
How Long Do Eligibility Specialist Employees Typically Stay in Their Roles?
On average, Eligibility Specialists works in this position for 3-5 years across multiple employers.
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Benefits CoordinatorHouston, TX - 11 months ago
3-5 years? That's not enough time to truly master the complexities of this job. Employers need to invest more in training and development. 😀
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HR ManagerMiami, FL - 11 months ago
As an HR Manager, I'm concerned about the turnover rate among Eligibility Specialists. We should work towards creating a positive and supportive work environment to retain talent. 🀝
What Is the Job Hopper Score for Eligibility Specialist Employees?
Moderate job changes in Eligibility Specialist, showing some career movement without excessive turnover.
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Software EngineerSeattle, WA - 11 months ago
πŸ€” I wonder if these moderate job changes in eligibility specialists are due to seeking better compensation and benefits.
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Restaurant ManagerLos Angeles, CA - 11 months ago
So we're just ignoring the fact that job changes may simply result from limited opportunities for growth in the food service industry? πŸ™„

Career path

Path to job

Discover a Eligibility Specialist's areas of knowledge sorted by their majors.
Explore the list of higher education institutions that a Eligibility Specialist typically studied at.
Central Michigan University
Ivy Tech Community College

Path after job

Community

Demographics

What Is the Age and Gender Ratio of Eligibility Specialist Employees?
Gender ratio in Eligibility Specialist position: 0.353741496598639 Male and 0.646258503401361 Female. Age ratio in Eligibility Specialist position: 16-20: 10%, 21-30: 66%, 31-40: 17%, 41-50: 5%, 51-60: 2%, 60+: 0%. Eligibility Specialist position is predominantly female (64.6%) with the largest age group being 21-30 years old, followed by 31-40 years old.
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Eligibility SpecialistPhoenix, AZ - 11 months ago
😀 It's disheartening to see that there's little representation for older eligibility specialists. Age discrimination may be at play here.
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Eligibility SpecialistPhiladelphia, PA - 11 months ago
πŸ™Œ Kudos to all the female eligibility specialists in their 30s. We're rocking this field!

Workplaces

Who Are the Top Employers for Eligibility Specialist?
Top employers of Eligibility Specialist position: Aetna, a CVS Health Company, State of Indiana, State of Michigan. People who work in Eligibility Specialist position most typically go on to work for the Aetna, a CVS Health Company.
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Eligibility SpecialistPhiladelphia, PA - 11 months ago
I've been applying to Aetna for ages and still haven't heard back. How can they be considered the top employer for Eligibility Specialists?
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Eligibility SpecialistPhoenix, AZ - 11 months ago
As an Eligibility Specialist working for the State of Michigan, I can say it's a fantastic employer with excellent benefits!
Aetna, a CVS Health Company
State of Indiana
State of Michigan
What Industries Does Eligibility Specialist Typically Have Experience In?
Industry Background: The most typical industries of Eligibility Specialist: Public Administration, Health Care, Professional / Scientific / Technical, Finance & Insurance, Religious / Grantmaking / Civic. Eligibility Specialist employees most likely come from a Public Administration industry background.
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Eligibility SpecialistHouston, TX - 11 months ago
Y'all ain't seen nothin' yet. Try being an Eligibility Specialist in the religious sector, where you deal with grantmaking. The emotional toll of deciding who gets funded and who doesn't is heavy on the soul.
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Eligibility SpecialistMiami, FL - 11 months ago
I work as an Eligibility Specialist in the professional and scientific industry, and let me just say, it's intellectually challenging and incredibly fulfilling. Love the puzzle solving aspect of it!

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Discussion about Eligibility Specialist

Want to know more about Eligibility Specialist position?
Share your thoughts and ideas about Eligibility Specialist position with others in our community.
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What is the women/men ratio in the job of Eligibility Specialist?
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Benjamin Gardner3 years ago
65% of the workforce being women.
How old are people who work as an Eligibility Specialist?
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Benjamin Gardner3 years ago
The typical age is 27 for an Eligibility Specialist.
Is an Eligibility Specialist considered to be a junior profession?
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Isabella Holmes3 years ago
You probably need around 6 years to work as an Eligibility Specialist
Which industries should an Eligibility Specialist consider working in?
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Isabella Holmes3 years ago
Public Administration is typical for an Eligibility Specialist to work in.
Is a higher education needed as an Eligibility Specialist?
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Sophie Hayes3 years ago
You should be fine with No higher education
Which company is likely to have openings for Eligibility Specialist positions?
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Sophie Hayes3 years ago
If you are an Eligibility Specialist you should definitely apply for Aetna, a CVS Health Company, State of Indiana, State of Michigan, State of Missouri and Xerox
How many years do people work as an Eligibility Specialist before changing their role?
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Liam Brown3 years ago
An Eligibility Specialist typically moves on after 4 years
How frequently people change companies if they work as an Eligibility Specialist?
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Liam Brown3 years ago
The job hopper score is medium for an Eligibility Specialist.
What work history do people usually have before becoming an Eligibility Specialist?
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Isabella Holmes3 years ago
Most people come from Customer Service Representative, Administrative Assistant or Case Manager roles
What typical professions people working as an Eligibility Specialist switch to?
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Liam Brown3 years ago
Consider the following: Customer Service Representative, Case Manager or Administrative Assistant
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