Eligibility Coordinator (Healthcare)
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.
- 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
Eligible
Compensation
$26.00 - $27.00 per hour
Location
San Leandro, In person
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