Eligibility & Benefits Specialist

HORIZON HEALTH AND WELLNESS INC•Queen Creek, AZ

1d•Onsite

About The Position

The Eligibility & Benefits Specialist serves as a resource for patients by providing clear information about their insurance benefits, explaining coverage limitations and exclusions, and assisting with arranging alternative financing options when needed. The position assists patients with applying for or reinstating coverage for Medicaid through Arizona Health Care Cost Containment System (AHCCCS) when applicable. The Eligibility & Benefits Specialist enters and updates patient benefit information in the agency’s management information system with accuracy and attention to detail. The individual verifies insurance coverage with carriers both online and by phone.

Requirements

High School diploma or GED
3 years related experience
Demonstrated knowledge of EHR functionality, including accurate data entry, document management, eligibility verification, and navigation of system features to support efficient workflow and compliance.
Must be at least 21 years of age or older.
Understand and maintain confidentiality in accordance with Agency policies.
Ability to work with minimal supervision.
Ensure data entry and research tasks are completed accurately, in a timely manner, and in accordance with established procedures.
Demonstrate the ability and willingness to work effectively with diverse populations.
Maintain flexibility and willingness to work evenings, weekends, and on an emergency basis as needed.
Working knowledge/familiarity with computers and electronic clinical record keeping.
Knowledge of Medical Terminology and familiar with insurance billing procedures.
Must obtain and maintain a fingerprint clearance card and pass a background check.
Prioritizing workload, decision-making ability, using sound judgment to field inquiries concerning administrative, clinical, and operational concerns.
Ability to greet and deal effectively with participants, families, staff, and facility visitors.
Long periods of sitting, ability to bend, lift and carry up to 20 pounds, do filing and move equipment.
Able to operate phone, Fax, copier, and a computer.

Nice To Haves

Prior office experience in a behavioral health setting.
Prior Behavioral Health insurance verification experience.
Bilingual - English/Spanish.

Responsibilities

Provide clear information about insurance benefits to patients.
Explain coverage limitations and exclusions.
Assist with arranging alternative financing options when needed.
Assist patients with applying for or reinstating coverage for Medicaid through AHCCCS.
Enter and update patient benefit information in the agency’s management information system.
Verify insurance coverage with carriers both online and by phone.