Eligibility Specialist

NaphCare • Birmingham, AL

13d • Onsite

About The Position

NaphCare has an excellent opportunity for an Eligibility Specialist to join our Corporate Headquarters in Birmingham, AL supporting our correctional health care clients. This position is on-site. The successful Eligibility Specialist will play a critical role in our operations by reviewing inmate eligibility and authorizations for medical procedures/appointments and reconciling claims. This position requires data entry skills and the ability to maintain a high volume of work with minimal errors. This employee will verify eligibility and serve as a liaison between the scheduling and claims department to assist with timely processing of claims.

Requirements

• High School Diploma or higher
• One (1) year minimum experience in a healthcare or claims setting
• Ability to prioritize and meet deadlines is critical in this role
• Working knowledge of medical terminology
• Strong written, verbal and organizational skills
• Working knowledge of claim demographic information
• Computer skills, including proficiency in Microsoft Office Suite, with an emphasis on Excel
• Must have the ability to maintain confidentiality of all proprietary and/or confidential information and integrity, professionalism and ability to adhere to a Code of Conduct and comply with all corporate policies, procedures, and legal requirements
• Must pass a criminal background check and drug screening

Responsibilities

• Review inmate demographics in patient management programs to verify eligibility for various dates of service.
• Utilize healthcare experience to consistently review medical authorizations in our scheduling system in order to resolve outstanding claims
• Demonstrate skills in accuracy and multitasking while working to impact progress within the daily workload and adhere to internal deadlines
• Maintain confidentiality when managing medical records, patient data, and NaphCare processes
• Demonstrate a high comfort level in working with large volumes of data
• Demonstrate a strong attention to detail
• Additional duties and specific projects as assigned

Benefits

• Health, dental & vision insurance that starts day one!
• Prescriptions free of charge through our health plan, beginning day one
• Lowest Cost Benefits!
• Employee Assistance Program (EAP) services
• 401(k) and Roth with company contribution that starts day one
• Tuition Assistance
• Referral bonuses
• Term life insurance at no cost to the employee
• Generous paid time off & paid holidays
• Free continuing education and CMEs

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees