Job Description
Overview
We are seeking a dedicated and detail-oriented Insurance Eligibility Representative to join our team. The ideal candidate will play a crucial role with spearheading benefits for our patients and bring on potential future patients as we continue to grow and support our community in Rehabilitation Sobriety . Ensuring compliance with regulations and providing support to patients regarding their benefits inquiries. This position requires strong analytical skills and a commitment to fostering positive relations.
Duties .
- Serve as the primary point of contact for our Housing Staff, Patients, and Revenue Cycle Services regarding benefits inquiries and issues.
- Ensure compliance with federal and state regulations regarding products.
Requirements :
- Strong understanding of Medicaid, Medicaid Managed Care, and other Insurance Benefit skill s .
- Strong background with AHCCCS, Availity, Mercy Care, etc. Provider Portals
- Effective communication skills to foster positive relations hip with Patients and Co-workers .
- Ability to handle sensitive information confidentially and professionally.
- A proactive approach to problem-solving with strong organizational skills.
- Resolves any issues with coverage and escalate any complications to supervisor/manager.
- Corrects identification and selection of appropriate registered insurance
- Corrects errors in various work queues to ensure correct claim filing or refiling of denied claims
- Performs other job duties as required .
Job Qualifications:
- High S chool G raduate or GED certificate is required .
- Candidate must demonstrate the ability to understand and navigate the insurance verification process including coordination of benefits, including in depth understanding of In /Out of Network Benefits and how they relate to co-insurance and deductibles due.
- Candidates must demonstrate strong customer service and patient focused orientation and the ability to communicate, adapt, and respond to complex situations. Including the ability to diffuse complex situations in a calm and professional manner.
- Must demonstrate effective communication skills both verbally and written.
- Ability to multi-task, prioritize, and manage time effectively.
- Functional proficiency in computer software skills ( e.g. Microsoft Word, Excel and Outlook, E-mail, etc.)
Preferred Not Required:
- Preferred Not Required: Prior EMR, KIPU and CMD System. (Preferred)
- A minimum of 6 months' experience in a physician billing or third-party payor environment.
- Knowledge of medical terminology, diagnosis and procedure coding is preferred
Work Location: Onsite:
Job Tags
Full time,