Insurance Eligibility and SFS Coordinator

Hope Christian Health Center Corp•North Las Vegas, NV

1d•$20 - $26

About The Position

The Insurance Eligibility and SFS Coordinator participates in the delivery of excellent medical services in a patient-centered medical home environment with an emphasis on the prevention of disease. By thoroughly verifying patient insurance eligibility, determining Sliding Fee Scale eligibility and maintaining accurate patient demographic and insurance information to support timely access to care and accurate reimbursement. This position ensures compliance with payer requirements, ensures accurate data entry and maintains the confidentiality of patient information while providing excellent and affordable healthcare.

Requirements

At least 1 (one) year of insurance verification in a medical clinic or facility - Required
Fluency in English - Required
Fluency in Spanish - Required
Knowledge of CPT and ICD-10-CM coding
Ability to operate general office machinery (computers, calculators, copy/fax machine, telephones, etc.)
Outstanding ability to build interpersonal relationships at all levels.
Excellent communication skills, both written and verbal.
Demonstrated passion for community health care.
Proven leadership, teambuilding, and organizational skills.
Proven ability to maintain integrity in a fast paced and high-demand environment.
Proven ability to manage performance goals.
Ability to interact with people from all ethnic backgrounds, ages, and lifestyles; ability to understand and respond appropriately, effectively, and sensitively to special populations

Nice To Haves

Faith to believe that Hope is a ministry of God, exemplifying the love of Christ, and held and directed by the Holy Spirit.

Responsibilities

Knowledge of medical insurance eligibility verification, payer guidelines, and coordination of benefits
Understanding of Medicare, Medicaid, Managed Care, and commercial insurance plans.
Ability to interpret Explanation of Benefits (EOB).
Verifies patient identity, medical insurance, establishes if patient is eligible for Sliding Fee Scale to ensure each visit accurate completion.
Reminds patients of upcoming appointments, follow-up visits, and referrals as applicable
Always maintains and ensures patient confidentiality
Updates the Electronic Medical Record (EMR) with accurate insurance information, demographic changes, primary care provider (PCP), co-pays, and coverage details. Corrects insurance entry errors that impact patient eligibility, laboratory billing, claims processing, and reimbursement.
Ensures patient insurance coverage and eligibility accuracy to prevent claim denials.
Provides accurate and detailed phone messages to other team members
Obtains patient consent/signature(s) when necessary
Reviews and reconciles Quest Diagnostics and LabCorp invoices for accuracy and completeness.
Investigates and disputes Quest Diagnostics and LabCorp billing discrepancies, including duplicate charges, incorrect patient information, insurance billing errors, and coding issues.
Research and corrects insurance eligibility, payer information, and demographic errors in the EMR to ensure accurate billing
Maintains safe, secure, and healthy work environment by establishing and following standards and procedures; comply with legal regulations
Ensures front office and clinic policies and procedures (as applicable) are always followed
Updates job knowledge by participating in educational opportunities; reading professional publications
Attends and actively participates in staff meetings
Performs all other duties as assigned
Maintains customer confidence and protects operations by keeping sensitive information confidential and always maintaining patient confidentiality.
Develops and maintains a tracking and dating system for SFS applications, number of patients apply for Medicaid.
In conjunction with the accounting department, monitors and resolves financial discrepancies.
Promotes and demonstrates Hope values of: Gospel motivation, Prayer, Excellence, Stewardship, Patience, Thankfulness, Humility, Service, Dignity through Relationship and Hospitality and Joy
Always maintains a courteous and professional demeanor.
Always maintains the confidentiality of Hope Christian Health Center finances and patient-related information.
Uphold Complies with HIPAA and protects patient information.
Ensures compliance with all 19 Health Resources and Services Administration (HRSA) Health Center Program Requirements.
Actively participate in and support quality improvement activities and the clinical practice team efforts emphasizing the importance of the individual patient and putting the patient’s needs first.