Eligibility Consultant Jobs

About the job Location: India 100% Remote Job type: Part-time, fixed-term internship Duration: 6 months Working commitment: 6 hours per day, 30 hours per week Working schedule: Partly flexible, with working hours coordinated in IST Compensation: Paid internship. Compensation will be agreed individually in writing with each selected candidate before the internship begins. The agreed compensation terms will be shared clearly before acceptance. Travel and relocation: No travel or relocation required Hiring entity: ACE MATES AB Work location eligibility: This internship is intended for applicants working remotely from India. Future opportunities: A full-time position may be considered after successful completion of the internship, but this is not guaranteed. Most internships hand you a textbook and ask you to fetch coffee. At ACE MATES, we hand you the keys to the AI revolution and ask you to build the operations that drive our growth. We operate in one of the fastest-growing domains in the world: cybersecurity, privacy, and compliance for the European market. We are not just selling solutions; we are redefining how business development works using agentic workflows, AI, and modern automation. We are looking for a techno-functional builder, someone who is not seeking a hardcore coding job or an aggressive cold-calling role, but wants to sit at the intersection of business, relationships, and cutting-edge technology. What’s In It for You? Mastery of Modern Ops You will not just learn about AI; you will use it daily. You will become a power user of Claude workspaces, n8n, and agentic workflows. High-Value Domain Knowledge You will learn the fundamentals of the European cyber, privacy, and compliance landscape, a highly valuable and future-proof career niche. End-to-End Ownership You will not be a cog in a machine. You will learn to build, test, and own workflows that directly impact our pipeline and customer relationships. A Builder Culture We are building the workforce

Dear candidates and job aspirants. Before speaking to us make urself decide first what is your requirement & we are service providers we charge for our service, if u wants best service we need to charge best charges apply We have openings in Software IT and NON IT .No need to pay anything before after offer letter complete verification process the further steps. We provide all genuine software IT related jobs through backdoor process, if anyone interested contact me 9989612735 (99and89and61and27and35)(Nine Nine Eight Nine Six One Two Seven Three Five) Please don’t prolong discussions in chat or call we are responsible to answer many calls and messages and also we need to follow up many calls to close profiles thank you for all your support and love Check eligibility criteria if everything matches those candidates only me others plz don’t Call To apply scan here

We’re Hiring Field Relationship Manager (FRM) About NoBroker NoBroker is a technology-driven real estate platform that aims to simplify the property-buying, selling, and renting experience by connecting property owners and customers directly. With a strong presence across major Indian cities, NoBroker provides technology-enabled solutions across the real estate journey. Job Role: Field Relationship Manager (FRM) Location: Bangalore Experience: 6 Months 3 Years Salary: Up to 5 6 LPA Working Days: 6 Days a Week Bike: Mandatory Valid Driving Licence: Mandatory Role Overview As a Field Relationship Manager, you will be responsible for building strong customer relationships, meeting clients in the field, generating business opportunities, and achieving sales targets. The role requires candidates who are comfortable with field travel and have strong communication and interpersonal skills. Key Responsibilities Build and maintain strong relationships with customers. Visit assigned locations to meet clients and provide support. Generate leads and convert them into business opportunities. Explain products/services and address customer queries. Achieve monthly sales and performance targets. Coordinate with internal teams for smooth customer onboarding and issue resolution. Maintain daily visit reports and update customer information. Eligibility & Requirements 6 months to 3 years of experience in Sales, Field Sales, Business Development, Relationship Management, or a similar role. Bike is mandatory for field travel. Valid Driving Licence is mandatory. Bike documents such as RC and Insurance must be available. Good communication and interpersonal skills. Kannada & English are mandatory. Hindi will be an advantage. What We Offer Petrol Allowance: Up to 4,000/month Attractive Performance-Based Incentives Early Promotion: Opportunity for promotion within 6 months based on performance Strong career growth opportunities Interested candidates can apply! Send

The HR Shared Services Compensation operations senior associate combines analytical rigour with a service-orientated mindset. They will be comfortable working in the details of HR systems and cases while also understanding the broader impact of compensation data and decisions on employees, managers, payroll, reporting, and business operations. We are looking to speak to candidates who are based in Gurugram for our hybrid working model. Key Responsibilities You will play a vital role in processing the backend transactions related to general compensation questions or tasks, along with making sure that the relevant SLA’s are met Review and process requests related to job architecture, job codes, career levels, compensation tiers, pay ranges, compa-ratio, salary positioning, bonus eligibility, and other compensation-related fields in the HRIS Pull ad hoc compensation reports, review data for accuracy and completeness, and help summarize basic findings for the compensation team and business partners Assist with program documentation, supporting records, data integrity, audit readiness, and compliance materials Partner with Compensation, HR Business Partners, Recruiting, Payroll, HRIS, Finance, and regional People Teams to investigate issues, resolve discrepancies, and coordinate end-to-end completion of transactions Adhere to and demonstrate high proficiency in agreed critical metrics & SLAs Create, maintain, and improve standard operating procedures, knowledge articles, checklists, process maps, and case-handling guidance for compensation processes Perform data validation, reconciliation, and quality-control checks across SuccessFactors, case-management tools, payroll inputs, compensation planning files, and downstream reporting systems Expected Skills Experience for 4+ years in HR Operations / Shared Services in an HR Shared Services role (EMEA and Americas) Strong Excel or spreadsheet skills, including data validation, lookups, filters, pivot tables, reconciliatio

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Review and adjust SF (self-funded), FI (fully insured), Reinsurance, and/or RX claims; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. Process provider refunds and returned checks. May handle customer service inquiries and problems. Perform adjustments across all dollar amount level on customer service platforms by using technical and claims processing expertise. Applies medical necessity guidelines, determine coverage, complete eligibility verification, identify discrepancies, and apply all cost containment measures to assist in the claim adjudication process. Performs claim re-work calculations. Follow through completion of claim overpayments, underpayments, and any other irregularities. Process complex non-routine Provider Refunds and Returned Checks. Review and interpret medical contract language using provider contracts to confirm whether a claim is overpaid to allocate refund checks. Handle telephone and written inquiries related to requests for pre-approvals/pre-authorizations, reconsiderations, or appeals. Ensures all compliance requirements are satisfied and that all payments are made following company practices and procedures. Review and handle relevant correspondences assigned to the team that may result in adj

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Senior Manager, Medicare Product Operations (NCOD) is responsible for providing leadership, operational oversight, and people management for the Non-Clinical Organization Determination (NCOD) team. This leader is accountable for ensuring accurate, timely, compliant, and member-centered coverage determinations while maintaining adherence to CMS regulations, and internal policies. The role oversees a team of managers and analysts responsible for evaluating member requests, issuing organization determinations, maintaining documentation, and supporting appeals- and grievance-related activities. This position serves as a key operational leader, driving quality, compliance, performance, process optimization, workforce development, and cross-functional collaboration. The Senior Manager partners with Compliance, Product, Appeals, Grievances, Eligibility, Technology, and vendor partners to ensure operational excellence and a best-in-class member experience. Responsibilities Include: Strategic Leadership Provides oversight for the NCOD operation, ensuring alignment with organizational goals, regulatory requirements, and member experience objectives. Establishes operational strategies, and performance standards that support long-term scalability and sustainability. Leads implementation of new NCOD workflo

At Freddie Mac, our mission of Making Home Possible is what motivates us, and it’s at the core of everything we do. Since our charter in 1970, we have made home possible for more than 90 million families across the country. Join an organization where your work contributes to a greater purpose. Position Overview: The Single-Family Law Department in the Freddie Mac Legal Division is seeking a collaborative, team focused attorney to join its legal staff as Assistant General Counsel. The attorney will support the single-family mortgage acquisition activities of Freddie Mac, including contract negotiations and drafting, written communications to the industry, internal and external training activities and communications, quality control matters, and new initiatives involving underwriting and purchasing single-family mortgages. Our Impact: Attorneys in the Single-Family Law Department of Freddie Mac’s Legal Division are key advisors to our business colleagues in the development and implementation of policies that support affordable and sustainable housing as part of Freddie Mac’s mission of making home possible. Your Impact: The Legal Division is committed to providing quality and timely advice and representation responsive to client needs on a variety of matters affecting Freddie Mac. As Assistant General Counsel in the Single-Family Law Department, you will: Advise internal clients on mortgage eligibility, credit policies and Freddie Mac Single-Family Seller/Servicer Guide (the “Guide”) matters, including lender eligibility; mortgage purchases; mortgage loan documents and forms; representations, warranties, covenants and remedies relating to lo

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Reviews and adjudicates complex, sensitive, and specialized medical claims in accordance with established plan processing guidelines. Functions as a subject matter expert by providing coaching, and offering guidance on escalated or technically challenging issues. Supports customer service operations by addressing inquiries and resolving issues to ensure a positive member experience. Additional Responsibilities - Reviews pre‑specified claims and those that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, determines coverage, verifies eligibility, identifies discrepancies, and implements cost‑containment measures to support accurate claim adjudication. - Ensures compliance with all regulatory requirements and confirms that payments align with company policies and procedures. - Identifies and reports potential overpayments, underpayments, and other claim irregularities. - Performs claim rework calculations as needed. - Trains and mentors as needed to enhance team performance and technical proficiency. - Conducts outbound calls to obtain required information for claims or reconsideration requests. Required Qualifications - Minimum of 18 months of medical claim processing experience with a health insurance payor or third‑party administrator. - Proven

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. This is a full-time telework position requiring 50-75% travel in the Metro East Regional counties, Illinois (Madison, St. Clair, Monroe, Clinton, Jersey, Calhoun, Macoupin, and Bond counties.) Hours for this position are Monday-Friday 8:00a-5:00pm Central Time. Position Summary The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process. The Case Management Coordinator facilitates appropriate healthcare outcomes for members by providing assistance with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources. • Evaluation of Members: Through the use of care management tools and information/data review, conducts comprehensive evaluation of member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services. • Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate. • Coordinates and implements assigned care plan activities and monitors care plan progress. • Enhancement of Medical Appropriateness and Quality of Care: Using holistic approach con

Current shift openings at this location:

Seasonal Warehouse Associate
Sunday, Monday, Tuesday 7:00PM-5:00AM
Sunday, Monday, Tuesday 6:00AM-4:00PM
Wednesday, Thursday, Friday, Saturday 7:00PM-5:00AM
Wednesday, Thursday, Friday, Saturday 6:00AM-4:00PM

 Apply to join our team today! Warehouse Associate roles starting at $22.75 per hour. The pay range is $22.75 to $26.00 per hour. You may also earn additional compensation in the form of a shift differential, ranging from $2.00 to $3.50 per hour, based on eligibility. Please apply with as much open availability as possible! As a progression TM, there is an opportunity to grow your pay based on your tenure in your role What does a role as a Warehouse Associate look like? Follow all safety policies and procedures to ensure a safe working environment for all team members. Attend safety trainings to learn how to work safely in a fast-paced warehouse environment. Pack, load, and ship items to stores and guests. Ensure accurate processing of merchandise to our stores and guests. Work safely, quickly, and efficiently to handle freight and move inventory throughout the warehouse. Maintain a neat, clean, and organized work area. Report to work on time and complete job tasks as assigned accurately and on time. Engage in problem solving to support continuous improvement. Maintains positive and respectful attitude while working independently and in a team environment. · Please note job duties may change at any time due to business ne

At Gilead, we’re creating a healthier world for all people. For more than 35 years, we’ve tackled diseases such as HIV, viral hepatitis, COVID-19 and cancer – working relentlessly to develop therapies that help improve lives and to ensure access to these therapies across the globe. We continue to fight against the world’s biggest health challenges, and our mission requires collaboration, determination and a relentless drive to make a difference. Every member of Gilead’s team plays a critical role in the discovery and development of life-changing scientific innovations. Our employees are our greatest asset as we work to achieve our bold ambitions, and we’re looking for the next wave of passionate and ambitious people ready to make a direct impact. We believe every employee deserves a great leader. People Leaders are the cornerstone to the employee experience at Gilead and Kite. As a people leader now or in the future, you are the key driver in evolving our culture and creating an environment where every employee feels included, developed and empowered to fulfil their aspirations. Join Gilead and help create possible, together. Job Description RESPONSIBILITIES: Provides input into or leads the development of the Target Product Profile and Clinical Development Plan for assigned molecules /products. Provides scientific and clinical guidance to cross-functional teams and colleagues to meet clinical development project deliverables and timelines. Provides input into, or otherwise leads, clinical trial protocol design, clinical study reports and health authority inquiries. Provides ongoing medical monitoring for clinical trials, including but not limited to assessment of eligibility criteria, toxicity management, and drug safety surveillance. Manages the clinical development component(s) in the prepar

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary - Supports comprehensive coordination of Medicaid and/or Medicare pharmacy services including intake and processing of pharmacy authorization requests. - Promotes and supports quality effectiveness of healthcare and Pharmacy Services. - Evaluates, authorizes approval, and communicates decisions for pharmacy requests according to clinical guidelines. - Evaluates and authorizes approval of pharmacy requests received by telephone, facsimile, and/or other means using client clinical criteria. - Determines appropriateness for medications. Communicates decision to physicians, physician’s office staff, medical management staff, members, and/or pharmacists. - Will perform clinical research to support request. - Performs non-medical research including eligibility verification, COB, and benefits verification. - Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements. - Process requests in compliance with various laws and CMS regulations and company policies and procedures. - May communicate with Aetna Case Managers, Health Plan Staff, External Pharmacies and Health Care Providers. - Promotes communication, both internally and externally, to enhance effectiveness of medication therapy management services. - Sedentary work involving significant periods of sitting, tal

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. A Brief Overview Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing. Contributes to the efficient and accurate handling of medical claims for reimbursement through knowledge of medical coding and billing practices and effective communication skills. What you will do Handles and processes Benefits claims submitted by healthcare providers, ensuring accuracy, efficiency, and strict adherence to policies and guidelines. Determines the eligibility and coverage of benefits for each claim based on the patient's insurance plan and policy guidelines and scope. Assesses claims for accuracy and compliance with coding guidelines, medical necessity, and documentation requirements. Documents claim information in the company system, assigning appropriate codes, modifiers, and other necessary data elements to ensure accurate tracking, reporting, and processing of claims. Conducts reviews and investigations of claims that require additional scrutiny or validation to ensure proper claim resolution. Communicates with healthcare providers, patients, or other stakeholders to resolve any discrepancies or issues related to claims.</sp

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. A Brief Overview Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing. Contributes to the efficient and accurate handling of medical claims for reimbursement through knowledge of medical coding and billing practices and effective communication skills. What you will do Handles and processes Benefits claims submitted by healthcare providers, ensuring accuracy, efficiency, and strict adherence to policies and guidelines. Determines the eligibility and coverage of benefits for each claim based on the patient's insurance plan and policy guidelines and scope. Assesses claims for accuracy and compliance with coding guidelines, medical necessity, and documentation requirements. Documents claim information in the company system, assigning appropriate codes, modifiers, and other necessary data elements to ensure accurate tracking, reporting, and processing of claims. Conducts reviews and investigations of claims that require additional scrutiny or validation to ensure proper claim resolution. Communicates with healthcare providers, patients, or other stakeholders to resolve any discrepancies or issues related to claims.</sp

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Location: Work From Home – Flexible, Travel Required: 25 – 50% (Wayne and Macomb Counties) Schedule: Standard business hours Monday-Friday 8:00am-5:00pm EST No evenings, weekends, or major holidays 4 day/10-hour schedule available after training ​ Our Mission The LTSS RN Case Manager is responsible for comprehensive assessment, care planning, coordination, implementation, and monitoring of Long-Term Services and Supports (LTSS) for dual-eligible Medicare and Medicaid members. This role ensures members receive appropriate waiver and community-based services to promote safety, independence, and improved health outcomes while maintaining regulatory compliance. This position includes in-home visits to complete functional assessments, evaluate eligibility for waiver services, and develop person-centered service plans. Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and