Eligibility Specialist - Financial Counseling

Valleywise Health•Phoenix, AZ

20h

About The Position

Under the direction of the Director of Patient Access, the Eligibility Specialist ensures that patients receiving services from Valleywise Health are properly screened for self-pay financial assistance. The role gathers thorough documentation, enters information into various systems, and monitors compliance policies. It ensures accurate and timely processing of accounts and registers patients while obtaining necessary verification of insurance and other eligibility programs. The position initiates and assists patients with completing AHCCCS applications and tracks and monitors their completion. It performs quality checks on eligibility and AHCCCS applications initiated in the department, ensuring they are processed for every self-pay or unverifiable payer source. The role also conducts quality assurance checks on the AHCCCS application program and works with management and other staff to identify and resolve issues that could affect billing and reimbursement.

Requirements

High school diploma or GED.
At least two years of progressively responsible interviewing or investigative experience obtaining confidential information.
Direct experience with the AHCCCS application process demonstrating an understanding of the required knowledge, skills, and abilities.
Valid fingerprint clearance card issued by the Arizona Department of Public Safety, or submission of a completed Affidavit at the time of hire. The fingerprint clearance card application must be completed within seven days of hire, and the actual card must be presented within 90 days of applying.
Excellent data-entry skills, including 10-key by touch.
Ability to type 30 words per minute accurately.
Basic math skills.
Ability to demonstrate interviewing and investigative techniques to obtain information that may not be offered.
Good verbal and written interpersonal and communication skills, including knowledge of basic grammar, spelling, and punctuation.
Ability to read, write, and speak effectively in English.
Ability to handle multiple tasks simultaneously.

Nice To Haves

Insurance verification experience.
Medicaid eligibility experience.
Critical thinking skills.

Responsibilities

Screen patients for self-pay financial assistance.
Gather thorough documentation and enter information into various systems.
Monitor and follow applicable compliance policies.
Ensure accurate and timely account processing and register patients.
Obtain necessary verification of insurance and other eligibility programs.
Initiate and assist patients in completing AHCCCS applications.
Track and monitor AHCCCS application completion.
Perform quality checks on eligibility and AHCCCS applications initiated in the department and ensure they are processed for every self-pay or unverifiable payer source.
Perform quality assurance checks on the AHCCCS application program.
Work with management and other staff to identify and resolve issues that threaten billing and reimbursement.