D201 - Eligibility Specialist

River Edge Behavioral Health • Macon, GA

3d

About The Position

Serving more than 10,000 Georgians, River Edge continues to be one of the state's leading resources for mental health, substance use disorder treatments and supports as well as individuals with intellectual and development disabilities. River Edge offers outpatient services at our Emery Highway-Macon, Monroe County and Baldwin County locations. Outpatient services include behavioral health, nursing, and psychiatric assessment, stabilization and medication maintenance services as well as crisis intervention services as well as awareness, education and recovery groups. River Edge Behavioral Health is actively seeking an Eligibility Specialist to join our dedicated team, ideally possessing attention to detail, strong analytical skills, effective communication, a team player mentality, adaptability, problem-solving abilities, ethical conduct, and organizational skills. Schedule: Monday to Friday: 8:30am- 5:00pm FLSA Classification: Hourly, Non-Exempt

Requirements

• High School Diploma or GED.
• 2-3 years of knowledge and experience in third-party payer and insurance verification.
• Minimum of two (2) years of customer service experience in a medical office environment.
• Ability to thrive in a fast-paced work environment, with strong organizational skills to manage multiple tasks efficiently.
• All applicants must pass a satisfactory background clearance and pre-employment drug test.
• Provide two (2) Professional Reference Statements (Former employers only; no family members).

Responsibilities

• Verify all commercial insurance, Medicaid, Medicare, and state program coverage to determine patient responsibility.
• Ensure client records contain up-to-date payer information, including authorization, Connects, treatment plan, Intake Assessment, annual updates, financial application, ANSA, or CANS.
• Update all third-party payer information in the clinical record, as necessary.
• Obtain prior authorization (non-clinical), if required.
• Determine third-party liability and co-payment, if applicable, and update the clinical record accordingly.
• Maintain accurate and current payer information in the clinical record to facilitate timely submission to all payors.
• Provide assistance to front desk staff as needed regarding insurance co-payments and coinsurance questions.

Benefits

• Competitive Pay
• Medical, Dental, Vision Insurance
• Paid Time Off
• 12 Paid Holidays
• 401k with an employer match
• Flexible Spending Accounts
• Short and Long-term disability coverage
• Life Insurance
• Employee Discount Program

What This Job Offers

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