Walk-in || Eligibility Representative

• EDM Operations & Data Management
• Maintain and update member records accurately in internal systems
• Perform data verification, quality checks, and audits to ensure data integrity
• Track and document all customer interactions, resolutions, and actions taken
• Identify and report data inconsistencies, operational risks, and process gaps
• Review healthcare plans, benefits, policies, and SOPs to provide accurate resolutions
• Ensure timely completion of transactions within established Service Level Agreements (SLAs)
• Maintain quality scores and productivity targets as per business expectations
• Customer & Stakeholder Support
• Handle customer, broker, employer group, and internal partner inquiries through email and voice support
• Respond professionally to member and client concerns while maintaining high customer satisfaction
• Follow up on unresolved cases and provide regular status updates
• Act as a point of contact for escalated or complex cases
• Problem Solving & Decision Making
• Analyze complex issues and determine appropriate resolutions independently
• Apply business knowledge and established guidelines to support decision-making
• Proactively identify solutions for non-standard requests and process exceptions
• Collaborate with cross-functional teams to resolve complex operational challenges

Documents to carry Resume, Adhar Card, Passport Size photo Must ( Mandatory ).