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:

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