Eligibility Coordinator Lead

Regal Medical Group • Los Angeles, CA

1d • $26 - $28

About The Position

Ensure that all EZCap system eligibility data is current and accurate.
Researches and maintains systems and changes to existing eligibility in a timely
manner.

Requirements

• High School Graduation or equivalency
• Courses in bookkeeping, accounting, insurance billing and data processing desirable.
• Minimum one year experience in a medical group/healthcare setting.
• Good verbal and written communication skills.
• Computer literate with keyboard skills for data entry.

Nice To Haves

• Knowledge of EZ-Cap preferred.

Responsibilities

• Performs research and analysis of membership
• Enters new member eligibility records into EZ Cap in accordance with established guidelines.
• Uses activity analysis reports from the health plans to make changes to existing enrollees; i.e. benefit option changes, terminations, and address changes.
• Manually audits existing eligibility in EZ Cap against current eligibility.
• Investigates retroactive cancellations for services rendered by the member after the policy termination date for eligibility guarantee.
• Researches problem eligibility on authorizations and/or claims forms by calling the health plans or utilizing any other source to resolve the problem.
• Assists personnel from other departments with eligibility issues.
• Any other duties as assigned by Lead or Department Head.
• Monitors queue, web site and email for inquiries.
• Responds timely to membership inquiries
• Perform other duties assigned by management.
• Proactively support and practice company mission, vision and values.
• Follow Employee Handbook guidelines and company policies and procedures.
• Follow established departmental dress code.
• Appropriately and accurately maintain time keeping records.
• Adhere to attendance policy and time off requests.
• Follow safety policies and procedures.
• Be flexible and adaptable and courteous and promote professionalism.
• Communicate verbally and in writing through appropriate channels.
• Maintain confidentiality at all times in compliance with company policy and HIPAA requirements.
• Employee has completed all required annual Compliance training and signed attestation form is attached for each module.

Benefits

• Employer-paid comprehensive medical, pharmacy, and dental for employees
• Vision insurance
• Zero co-payments for employed physician office visits
• Flexible Spending Account (FSA)
• Employer-Paid Life Insurance
• Employee Assistance Program (EAP)
• Behavioral Health Services
• 401k Retirement Savings Plan
• Income Protection Insurance
• Vacation Time
• Company celebrations
• Employee Assistance Program
• Employee Referral Bonus
• Tuition Reimbursement
• License Renewal CEU Cost Reimbursement Program
• Business-casual working environment
• Sick days
• Paid holidays
• Mileage

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 501-1,000 employees