Eligibility Specialist

SCP Health•Lafayette, LA

4d•$15 - $21•Hybrid

About The Position

Responsible for accurately resolving registration and eligibility edits, related to the demographic and/or insurance information, based on departmental policies and procedures and feedback received from various payors. Assist chart flow through the PreBilling processes and maintain inventory levels to ensure timely, effective, and accurate chart processing while maximizing revenue.

Requirements

Detail oriented and organized
Self-motivated; capable of compiling/tracking data to meet deadlines and goals
Excellent interpersonal skills
Ability to work equally well individually and in a team environment
Professional attitude and demeanor
Written and oral communication skills
Proficient computer knowledge of Word, Excel, Windows and Outlook
Quick learner with an aptitude for custom computer systems
Previous success and comfort with entering data for extended time periods and limited interruptions
Contact insurances via phone call for complex edits
One year experience in a medical (billing preferably) environment
One year experience in a fast-paced production environment
High school diploma or equivalent

Nice To Haves

One year experience (preferred) verifying eligibility with various insurance carriers
Business or healthcare related field

Responsibilities

Update demographics and/or insurance information based on feedback provided by internal or payor edits, using available resources: face sheets, insurance cards, eligibility results etc.
Determine the appropriate insurance carrier and billing information from the data contained in the patient’s medical record and use that information to accurately update a patient’s account in the billing system
When insufficient or questionable data is supplied in the medical record, contact the appropriate insurance carrier or facility to acquire accurate data
Utilize the Eligibility process/data in Centricity or on the payors’ websites to obtain more accurate information on each patient returned with an edit
Request additional insurance company entries in Centricity when necessary
Request direction and clarification from supervisor or lead when necessary, in order to assure accurate resolution of edits
Identify and work complex edits presented from various sources
Identify and report results of user and/or system issues that impact billing quality
Maintain understanding of current departmental policies and procedures
Promote a team environment that will support the growth of every department member and achievement of all department goals as a result of team work
Actively participate in meetings and educational programs in an effort to improve both individual and team quality and effectiveness