Eligibility & Systems Coordinator

ABOUT THE ROLE:

The Eligibility & Systems Coordinator plays a critical role in ensuring the seamless execution of eligibility-related processes and Advocate system configurations. This role serves as a key liaison between internal teams, clients, and technical partners, addressing work that falls between multiple teams. The coordinator will focus on monitoring, troubleshooting, and resolving eligibility file issues, as well as supporting post-implementation product configurations to ensure operational efficiency and accuracy.

This role is ideal for a highly detail-oriented and tech-savvy individual with strong troubleshooting skills, curiosity for problem-solving, and the ability to communicate complex technical concepts in a professional and accessible manner. This role requires proactive problem-solving and the ability to work autonomously while escalating complex issues as needed. The ideal candidate will bring a continuous improvement mindset, looking for ways to enhance processes and reduce recurring issues. Strong documentation skills are a plus, as this role may contribute to internal knowledge bases and troubleshooting guides.

WHAT YOU’LL DO:

Eligibility Service & Enrollment Support

• Monitor eligibility file uploads to ensure successful ingestion and processing.
• Identify and analyze fallout reports to detect upload errors and discrepancies.
• Investigate and troubleshoot file and individual enrollment errors, working to resolve issues in a timely manner.
• Collaborate directly with client contacts, internal Product teams, and Tech teams to resolve eligibility-related challenges.
• Manually load ad hoc eligibility files and run transformers for accumulator files, ID card information, and other eligibility-related processes.

Product Configuration & System Support

• Assist with post-implementation configuration updates in the Admin platform when client services or plan designs change.
• Perform preliminary troubleshooting of system configurations across Admin, CMS, and Eligibility Service to determine root causes of Advocate-facing issues.
• Identify and escalate configuration gaps that impact the user experience or service delivery.
• Support miscellaneous projects as needed to support troubleshooting, configuration, and general enablement requests. 

WHO YOU ARE:

• High attention to detail, with the ability to quickly identify inconsistencies and anomalies.
• Strong analytical and troubleshooting skills to investigate and resolve file ingestion and system configuration issues.
• Technical aptitude, with the ability to learn and navigate multiple systems (e.g., Admin, CMS, Eligibility Service).
• Excellent problem-solving mindset, demonstrating curiosity and persistence in resolving complex issues.
• Effective communication skills, with the ability to convey technical information to non-technical stakeholders.
• Professionalism in client interactions, maintaining a clear and solution-oriented approach.
• Ability to work cross-functionally, collaborating with internal teams (Operations, Product, Tech, Client Services) to drive resolutions.

EXTRA CREDIT:

• Experience working with eligibility files, enrollment systems, or benefits administration platforms.
• Familiarity with data file structures (e.g., EDI 834, XML, JSON, CSV) and troubleshooting data ingestion issues is preferred but not required.
• Prior experience working in a healthcare, insurance, or benefits-related role is a plus.
• Exposure to system configuration and troubleshooting within various platforms.

HOURLY COMPENSATION:  

$26-$31/hr

CYBERSECURITY AWARENESS NOTICE

In response to ongoing and industry-wide fraudulent recruitment activities (i.e., job scams), Rightway wants to inform potential candidates that we will only contact them from the @rightwayhealthcare.com email domain. We will never ask for bank details or deposits of any kind as a condition of employment. 

ABOUT RIGHTWAY:

Rightway is on a mission to harmonize healthcare for everyone, everywhere. Our products guide patients to the best care and medications by inserting clinicians and pharmacists into a patient’s care journey through a modern, mobile app. Rightway is a front door to healthcare, giving patients the tools they need along with on-demand access to Rightway health guides, human experts that answer their questions and manage the frustrating parts of healthcare for them.

Since its founding in 2017, Rightway has raised over $205mm from investors including Khosla Ventures, Thrive Capital, and Tiger Global. We’re headquartered in New York City, with a satellite office in Denver. Our clients rely on us to transform the healthcare experience, improve outcomes for their teams, and decrease their healthcare costs.

HOW WE LIVE OUR VALUES TO OUR TEAMMATES:

We’re seeking those with passion for healthcare and relentless devotion to our goal. We need team members that embody our following core values:

1) We are human, first
Our humanity binds us together. We bring the same empathetic approach to every individual we engage with, whether it be our members, our clients, or each other. We are all worthy of respect and understanding and we engage in our interactions with care and intention. We honor our stories. We listen to—and hear—each other, we celebrate our differences and similarities, we are present for each other, and we strive for mutual understanding.

2) We redefine what is possible
We always look beyond the obstacles in front of us to imagine new solutions. We approach our work with inspiration from other industries, other leaders, and other challenges. We use ingenuity and resourcefulness when faced with tough problems.

3) We debate then commit
We believe that a spirit of open discourse is part of a healthy culture. We understand and appreciate different perspectives and we challenge our assumptions. When working toward a decision or a new solution, we actively listen to one another, approach it with a “yes, and” mentality, and assume positive intent. Once a decision is made, we align and champion it as one team.

4) We cultivate grit
Changing healthcare doesn’t happen overnight. We reflect and learn from challenges and approach the future with a determination to strive for better. In the face of daunting situations, we value persistence. We embrace failure as a stepping stone to future success. On this journey, we seek to act with guts, resilience, initiative, and tenacity.

5) We seek to delight
Healthcare is complicated and personal. We work tirelessly to meet the goals of our clients while also delivering the best experience to our members. We recognize that no matter the role or team, we each play a crucial part in our members’ care and take that responsibility seriously. When faced with an obstacle, we are kind, respectful, and solution-oriented in our approach. We hold ourselves accountable to our clients and our members’ success.

Rightway is Proudly an Equal Opportunity Employer that believes in strength in the diversity of thought processes, beliefs, background and education and fosters an inclusive culture where differences are celebrated to drive the best business decisions possible. We do not discriminate on any basis covered by appropriate law. All employment is decided on the consideration of merit, qualifications, need and performance.