Insurance Eligibility Representative

Job Description

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 skills.

• Strong background with AHCCCS, Availity, Mercy Care, etc. Provider Portals

• Effective communication skills to foster positive relationship 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 School Graduate 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:

As part of our commitment to maintaining a safe and productive work environment, Sanctuary Recovery Centers conducts background checks and drug screenings for all potential employees. Please note the following:

1. Background Check : All offers of employment are contingent upon the successful completion of a background check. This may include verification of employment history, education, criminal records, and other relevant information.

2. Drug Screening : Candidates must pass a drug screening test as a condition of employment. This test will screen for the presence of illegal substances and may include random testing during employment.

3. APS Registry : Candidates must pass an APS (Adult Protective Services) registry check before an offer of employment can be extended.

4. Confidentiality : All information obtained during the background check, drug screening, and APS registry check process will be kept confidential and used solely for employment purposes.

5. Compliance : Sanctuary Recovery Centers complies with all applicable federal, state, and local laws regarding background checks, drug screenings, and APS registry checks.

By applying for this position, you acknowledge and consent to these procedures.