Eligibility Specialist Bilingual - Sharpstown

Legacy Community Health • Houston, TX

127d

About The Position

At Legacy Community Health, we are catalysts for change, pioneering a new era of healthcare accessibility. As an Eligibility Specialist, you will be at the forefront of revolutionizing patient access to vital health services through innovative solutions and data-driven methodologies. Leverage cutting-edge technology to determine applicant eligibility for third-party reimbursement, streamline the admission process for new patients using state-of-the-art data systems, and enhance patient experience by ensuring precision in insurance billing through advanced coding techniques. Transform community health by addressing inquiries from prospective applicants and patients innovatively.

Requirements

• High School Diploma or GED, augmented by a foundation in medical knowledge
• Preferably 3-5 years of breakthrough experience in medical billing
• Training or background in ICD-A / CPT codes, enhancing precision in billing
• Proficiency in bookkeeping and accounting terminology, with a tech-savvy edge
• Hands-on experience with digital systems and office technology
• Proven capability to take initiative and perform under pressure in a fast-paced environment
• Bilingual capabilities preferred, supporting diverse community engagement
• Knowledge of medical terminology and billing practices, propelling operational excellence

Responsibilities

• Deploy agile methodologies in eligibility determination for clients, ensuring compliance with program-specific protocols
• Innovatively verify that clients lack other payer sources such as Medicaid, Medicare, or third-party insurance
• Utilize the latest technology to register clients into the CPCDMS efficiently
• Ensure meticulous completion of all necessary paperwork, optimizing digital entry for eligible clients
• Maintain cutting-edge, up-to-date eligibility files using a data-driven approach
• Champion renewal eligibility processes as required by each program, ensuring seamless client support
• Engineer confirmation of eligibility appointments and orchestrate initial service scheduling post-eligibility
• Equip clients with comprehensive lists of required eligibility documentation
• Active participation in our disruptive Performance Improvement Program
• Advocate for a culture of respect, fostering dignity for all patients and employees
• Drive effective collaboration within dynamic team environments
• Engage in crucial safety training and adhere to advanced safety protocols
• Maintain workspace and technology in alignment with Legacy's high standards
• Implement Legacy’s strategic exposure control plans for health safety
• Master protective barrier equipment, techniques, and procedures
• Commit to annual educational advancements
• Flexibility to travel for training and coverage, embracing a mindset of continuous improvement
• Contribute to additional game-changing duties as assigned

Benefits

• Paid Time Off & Paid Company Holidays
• Medical, Dental, Vision & Life Insurance
• Flexible Spending Account (FSA)
• 403(b) Retirement Plan with Company Match
• Short-Term & Long-Term Disability
• $0 Copay for Legacy Provider visits
• $0 Copay for prescriptions filled at Legacy Pharmacies
• Travel Insurance & Pet Insurance
• Subsidized Gym Membership
• And much more!

What This Job Offers

• Education Level: High school or GED
• Number of Employees: 1,001-5,000 employees