Eligibility Coordinator

Employment Type

Full-Time

Job Description

The Eligibility Coordinator performs patient intake and eligibility services for all clinic (medical, dental & behavioral health) and counseling services, and performs responsibilities with accuracy, professionalism and excellent customer service. All Eligibility Coordinators are cross-trained to support all departments within the clinic and provide back-up coverage as needed.

Responsibilities

  • Responsible for contacting insurance companies and navigating payer websites to obtain accurate status information of outstanding claims and inputs accurate information into the computer billing system.
  • Resolve insurance eligibility denials through various methods such as website research, calling insurance companies to verify coverage and benefits or by contacting the facility and/or the patient.
  • Assisting in identifying and resolving payer trends and issues related to eligibility denials and rejections.
  • Assist patients in the enrollment of local, state, and federal programs
  • Assist patients with scheduling appointments for clinic and counseling services.
  • Research insurance eligibility via website or by calling the insurance company, patient, or hospital in order to resolve eligibility denials/rejections in a timely and accurate manner.
  • Correct and repost claims as requested by billing department with correct patient information.
  • Responsible for submitting corrected claims to appropriate payers in a timely manner if needed.
  • Ensures compliance with state and federal laws and regulations for Commercial, Medicare, Medicaid, Managed Care and other payers.
  • Maintains ongoing knowledge of Health Resources Services Administrative (HRSA) and other mandatory state billing forms and filling and follow up requirements and ensures compliance and adherence to guidelines.
  • Responsible for all daily productivity reporting requirements.
  • Performs administrative functions and general office duties as assigned.
  • Maintains and exceeds department standards for productivity and quality.
  • Maintains confidentiality in accordance with HIPAA.
  • Participates in outreach community events to engage and enroll patients.
  • Other duties as assigned

Requirements

  • 1+ year related experience with working knowledge of insurance coverages, eligibility, verifications, medical billing guidelines and navigating payer websites.
  • High School Diploma
  • Bilingual-Chinese Speaking
  • Excellent customer service, communication and interpersonal skills, with the ability to effectively interact with patients, healthcare providers, insurance representatives and others.
  • Cultural sensitivity and demonstrated ability to work with diverse people groups.
  • Commitment to the mission and values of Davis Street.

Benefits

  • Mission-driven company culture
  • 100% paid employee premium for Kaiser, Dental, Vision and Life Insurance plans.
  • 403(b) Retirement plans with matching contributions
  • Paid Time Off for vacation and illness
  • 12 Paid Holidays PLUS an additional paid birthday holiday
  • Employee Discount Program
  • and more!

Compensation

$26-$27 per hour

Location

ON-SITE

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