Eligibility Specialist

Responsibilities:

• Update demographics and/or insurance information based on feedback provided by internal or payor edits, using available resources: face sheets, insurance cards, eligibility results etc.
• Determine the appropriate insurance carrier and billing information from the data contained in the patient’s medical record and use that information to accurately update a patient’s account in the billing system
• When insufficient or questionable data is supplied in the medical record, contact the appropriate insurance carrier or facility to acquire accurate data
• Utilize the Eligibility process/data in Centricity or on the payors’ websites to obtain more accurate information on each patient returned with an edit
• Request additional insurance company entries in Centricity when necessary
• Request direction and clarification from supervisor or lead when necessary, in order to assure accurate resolution of edits
• Identify and work complex edits presented from various sources
• Identify and report results of user and/or system issues that impact billing quality
• Maintain understanding of current departmental policies and procedures
• Promote a team environment that will support the growth of every department member and achievement of all department goals as a result of team work
• Actively participate in meetings and educational programs in an effort to improve both individual and team quality and effectiveness
• Knowledge, Skills and Abilities:
• Detail oriented and organized
• Self-motivated; capable of compiling/tracking data to meet deadlines and goals
• Excellent interpersonal skills
• Ability to work equally well individually and in a team environment
• Professional attitude and demeanor
• Written and oral communication skills
• Proficient computer knowledge of Word, Excel, Windows and Outlook
• Quick learner with an aptitude for custom computer systems
• Previous success and comfort with entering data for extended time periods and limited interruptions
• Pay Range:
• This range represents the anticipated base salary for this role. Actual compensation will be determined based on experience, qualifications, and internal equity considerations.
• We offer a comprehensive benefits package designed to support your health, financial well-being, and work-life balance, including medical dental, vision insurance, a 401(k) plan with a company match, paid time off and holidays, professional development support, and employee wellness resources.
• Visit our website for further information. https://myscpbenefits.com/
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