Eligibility Screener- Escondido, CA

ARstrat • Escondido, CA

12h • Onsite

About The Position

An Eligibility Screener is responsible for verifying patient insurance coverage, reviewing financial and demographic information, and determining eligibility for healthcare benefits or assistance programs. This role works directly with patients, insurance companies, and healthcare systems to ensure accurate information is obtained prior to services being provided, helping reduce billing issues and claim denials. Responsibilities include insurance verification, patient communication, documentation, data entry, and maintaining compliance with HIPAA and company policies. If you are a caring, compassionate individual with a sense of community, we have a rewarding career available for you. Do you want to help those within need in your community? Would you be interested in assisting healthcare patients to find insurance to assist with their medical bills? Work in a local hospital assisting patients with applications for third-party resources including state aide.

Requirements

• High School diploma or General Educational Development (GED) certificate or equivalent in relevant work experience desired.
• Previous healthcare coverage/eligibility experience preferred.
• Proficient personal computer skills including Microsoft Office.
• Ability to maintain the highest level of confidentiality.
• Bilingual (Spanish) a plus.
• Excellent interpersonal, written, and oral communication skills.
• Willing to work inside of a hospital including visiting hospital rooms to complete tasks
• Ability to work in a team fostered environment.
• Ability to work in a multi-tasked environment.
• Ability to prioritize and organize work.
• Ability to adapt to a flexible schedule.

Nice To Haves

• Previous healthcare coverage/eligibility experience preferred.
• Bilingual (Spanish) a plus.

Responsibilities

• Maintain the appropriate level of work activity according to work standards and establish work processes to ensure timely certification for eligibility programs.
• Retrieve and forward requested records and information, including medical records, insurance policy information, remittance advice, and itemized statements, to appropriate parties.
• Analyze, distribute, and follow-up on special requests and adjustments with hospital personnel.
• Maintain consistent proactive communication with the patient or patient representative throughout the eligibility process, keeping the patient informed of the account progress.
• Screen patients and/or patient representatives to determine potential eligibility for Third Party resources.
• Communicate effectively with physicians, case managers, social workers, and hospital business office staff on a daily basis to ensure questions are answered and issues are addressed.
• Educate patients and patient representatives of the eligibility requirements, application process, and verification requirements for applicable programs.
• Maintain a professional relationship with the patient and governmental agencies to ensure cooperation and compliance.
• Document pertinent patient information and all work activity in the appropriate systems dictated by company policies and procedures.
• Ensure accounts are processed in accordance to Eligibility Program standards, Client expectations, and all applicable federal and state regulations guidelines.
• Responsible for understanding and complying with all policies, procedures, and regulations relating to job duties.
• Perform other duties as assigned by management.

Benefits

• Comprehensive Health Coverage: Enjoy medical, dental, and vision plans available starting after 60 days of full-time employment.
• Life & Disability Insurance: Benefit from basic life/AD&D, short-term, and long-term disability coverage, with optional voluntary life/AD&D plans.
• 401(k) Plan: Eligible to participate in the company’s 401(k) plan after 6 months of continuous service.
• Paid Time Off (PTO): Start accruing PTO from your very first day of employment.
• Flexible Benefits: Customize your benefits package to fit your personal and family needs.
• Quarterly Bonus Eligible

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED