Billing Eligibility Specialist (Temp)

Neighborhood Healthcare•Escondido, CA

6d•$23 - $32•Hybrid

About The Position

The Billing Eligibility Specialist works to support the mission and vision of Neighborhood Healthcare by assisting patients with insurance eligibility issues. This role will confirm and work with patients to resolve billing and insurance related issues. In addition, this role will manage the insurance verification and eligibility functions in eCW. This position is temporary, and the assigned end date of 04/28/2027 is tentative. Please note, this is a hybrid role and the typical schedule for this position is Monday through Friday, 7 AM to 4 PM with a 1-hour lunch break.

Requirements

High school diploma/GED required
One year electronic health record systems is required; eCW is preferred
Excellent verbal and written communication skills, including superior composition, typing and proofreading skills
Ability to interpret a variety of instructions in written, oral, diagram, or schedule form
Knowledgeable about and experience with medical office procedures and billing insurance carriers, including Medicare and Medicaid
Knowledgeable about insurance eligibility processes and coverage guidelines for multiple carriers
Ability to successfully manage multiple tasks simultaneously
Excellent planning and organizational ability
Ability to work as part of a team as well as independently
Ability to work with highly confidential information in a professional and ethical manner
Follow all safety procedures as outlined in Neighborhood Healthcare’s Illness and Injury Prevention Plan (IIPP) and report any injuries and/or unsafe conditions immediately
Maintain current knowledge of policies and procedures as they relate to safe work practices
Follow all safety procedures and report unsafe conditions
Use appropriate body mechanics to ensure an injury free environment
Be familiar with location of nearest fire extinguisher and emergency exits
Follow all infection control procedures including blood-borne pathogen protocols
Maintain privacy of all patient, employee and volunteer information and access such information only on a need-to-know basis for business purposes
Comply with all regulations regarding corporate integrity and security obligations
Report all behavior and/or activity that are unethical, fraudulent, or unlawful

Nice To Haves

Two years’ medical front office experience is preferred
Medical Office Assistant certification is preferred
Bilingual (English/Spanish) as required by site

Responsibilities

Completes insurance verifications and places electronic notes in eCW accurately and timely
Performs batch and individual eligibility verifications utilizing the Insurance Eligibility (IE) function in eCW
Submits electronic insurance verifications through eCW, insurance website portals, or calls insurance companies to inquire about eligibility, benefits information, and payment for services
Maintains knowledge of all contracted insurances and programs accepted at NHC
Provides direct support to clinics regarding eligibility inquiries
Validates insurance eligibility, benefits, and financial information required for billing and collection processes
Completes a high volume of benefit verification requests
Initiates three-way calls with patients and insurance carriers to perform primary care provider (PCP) changes
Informs patients of their benefits and financial responsibilities, as needed
Applies Sliding Fee Discount Program (SFDP) discounts to patient changes, as necessary
Validates declaration of income documentation is secured and valid
Provides thorough customer service internally and externally with professionalism, courtesy, and knowledge
Participates in various projects and team meetings