Eligibility Specialist

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Job description

Eligibility Specialist

Duties and Responsibilities:

• Verify patient insurance coverage to ensure eligibility and determine patient responsibility (deductible, copay, coinsurance) prior to each patient visit.

• Works directly with multiple insurance websites for benefits and authorization/referral validation.

• Maintains a clear understanding of the different insurance products accepted by Gladstone and can articulate them to patients and staff.

• Determines estimated patient financial responsibility using insurance verification information and payer contracts and/or self-pay guidelines.

• Email patient's appointment confirmation with provider's name, location, date, time and cost of visit.

• Making sure that patients are aware of the cost for no show/late fee when canceling appointments via email.

• Contact patients via phone or email periodically to explain service cost if applicable.

• Maintain strict patient confidentiality and Federal HIPPA regulation.

• Coordinates work efforts with other team members to achieve an efficient workflow and time adherence within the office.

• Perform other office duties as assigned by manager.

Knowledge, Skills and abilities:

• Understanding of various health insurance plans

• Understand the appropriate payment rates for corresponding services based on individual contractual agreements or fee schedules

• Ability to communicate clearly and effectively both orally and in writing

Qualifications:

• Computer literate and able to read, write, and speak the English language in an understandable manner, and be able to follow written and oral instructions.

• Must be flexible, have personal integrity, and the ability to function effectively as a team member.

• Good organizational skills/ detailed oriented

• High school diploma or equivalent or any combination of education or training

• Minimum of 1-year experience verifying mental health insurance

• Minimum 5+ customer service experience

• High volume call center experience

Job Type: Full-time

Pay: From $17.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

Education:

• High school or equivalent (Preferred)

Experience:

• Customer Service: 1 year (Preferred)
• Insurance Eligibility: 1 year (Required)
• Medical billing: 1 year (Required)
• Mental Health Terminology: 1 year (Preferred)

Language:

• Bilingual (Preferred)

Work Location: One location