Eligibility Specialist

Medical Associates of NWA • Fayetteville, AR

5d • Onsite

About The Position

The Eligibility and Benefit Specialist is responsible for the timely verification of medical insurance benefits. This role involves verifying that insurance information in the file is active and correct prior to patient appointments. The specialist will use online tools or make calls to private insurance companies, Medicare, and Medicaid to obtain benefit information, determine insurance compatibility with the health-care provider, and notify the ordering physician and patient if the provider is out of network. Additionally, the specialist will estimate patient financial responsibility based on deductibles, out-of-pocket costs, co-pays, and contracted fee schedules, coordinate with patients regarding their insurance benefits, and make courtesy calls prior to appointments to inform patients of their financial responsibilities. All patient contact must be documented in the eCW system.

Requirements

• Equivalent to four years high school or GED, with particular emphasis during high school in office skills, shop skills, or others
• 12 to 18 months of eligibility experience and/or training, or equivalent combination of education and experience.

Responsibilities

• Uses online tools or calls private insurance companies, Medicare, and Medicaid to obtain benefit information.
• Determines insurance compatibility with health-care provider.
• If provider is out of network, notifies ordering physician and patient.
• Determines the estimate of patient financial responsibility according to deductibles, out of pocket, co-pay, and contracted fee schedules.
• Coordinates with patients regarding their insurance benefits.
• Makes courtesy call to patients priorto appointment to make patient aware of any deductible, out of pocket, or co-pay financial responsibility.
• Documents patient contact in eCW system.

Benefits

• Comprehensive Benefits – Medical & dental
• 401(K) match and profit sharing
• Up to 21.5 paid days off (PDO, EID and Perfect Attendance benefits) & 6 days paid holidays
• Employer paid life, long-term & short-term disability benefits
• Corporate Discounts: MANA has partnerships with various local and nationwide retailers to provide discounts to you; Dell, ATT, Verizon, and many more!
• One-On-One Training and Development

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED