Claims ProcessorAppleOne

AppleOne, a division of the Act-1 Group, is proud to present:

Eligibility Specialist / Application Claims Processor
Long-Term Contract | Potential for Permanent Placement

100% Onsite Columbia, SC 29223

MondayFriday, 8:30 a.m.5:00 p.m.

$15/hour

Start date: 11/23, training will be 3-4 weeks and time off during training is not permitted.


We are partnering with a state agency to hire Eligibility Specialists for a long-term contract opportunity in Columbia, SC. This role is ideal for candidates who are analytical, detail-oriented, and comfortable working in a structured, fast-paced environment focused on case ownership and policy review.

This position is heavily focused on critical thinking and case analysis. While there is a customer service component, the majority of the role involves reviewing documentation, analyzing eligibility factors, applying policy, and managing cases from start to finish, including re-determinations.
Most successful candidates have come from prior healthcare administration/claims, insurance, or research-based positions.



Key Responsibilities

•Review and analyze applicant documentation for eligibility determination
•Maintain ownership of assigned cases from start to finish
•Handle re-determinations and ongoing eligibility reviews
•Apply policies and procedures accurately across multiple systems
•Communicate professionally with applicants regarding documentation or clarification needs
•Manage workload efficiently while maintaining quality standards
•Maintain confidentiality and program integrity
•Work independently after training in a cubicle-style environment



Qualifications

•Strong computer and typing skills
•Ability to communicate professionally both verbally and written
•Proficiency with Microsoft Office and ability to learn new systems quickly
•Strong attention to detail and organizational skills
•Ability to analyze information and think critically
•Comfortable navigating multiple screens and systems simultaneously
•Ability to follow structured processes and policies consistently
•Basic math computation skills preferred