Eligibility Specialist

Wesley Family Services is seeking an attentive and detail driven Eligibility Specialist to join our Finance team. The Eligibility Specialist is responsible for activities involved with authorization of services and other pre-billing/activities. Eligibility is responsible for employee credentialing application and maintenance for all payers. This position regularly coordinates with all payers of services provided. This position also processes authorization for the program and assures accuracy of client eligibility and authorization status.

You can get further details about the nature of this opening, and what is expected from applicants, by reading the below.

Minimum Requirements:

• Education: Minimum of a high school diploma or GED. Human Services or Business certificate or degree preferred.
• Experience: 3 years of providing administrative support, relative to medical office or human services field AND 3 years advanced level experience and proficiency with Microsoft Office applications, including word, PowerPoint, excel, access, outlook.
• Licenses, Certifications & Clearances: PA Child Abuse, PA Criminal, and FBI Background Clearances obtained prior to start.

Responsibilities and Duties (full description available at )

• Runs eMedical daily for assigned programs.
• Updates electronic medical record (EMR) with insurance changes.
• Updates and enters authorizations and re-authorizations into electronic medical record timely.
• Reviews plans and ensures commercial insurance is maintained throughout consumer treatment, updates EMR as needed to ensure correct billing.
• Follows close out procedures.
• Responsible for ACT 62 compliance as applicable to individual consumers.
• Manages the pre-closing report to make sure that all active clients are receiving services.

Wesley Family Services offers the following benefits:

ALL EMPLOYEES:

• Tuition discounts - up to a 20% discount on tuition for certain degree programs at local partnering colleges
• Annual performance evaluations with pay increase eligibility
• Employee Assistance Program
• Free licensure supervision (minimum work hours may apply)
• WFS Wellness Center
• myStrength
• Discounted home, auto, and pet insurance

FULL TIME EMPLOYEES:

• 10 paid holidays + paid Celebration Day
• 15 paid time off days 1st year, 20 paid time off days 2nd year, continues to increase
• Tuition reimbursement for qualifying courses of up to $2,000 per semester or course ($6,000 per fiscal year maximum reimbursement)
• Medical, dental, and vision insurance (effective the 1st of the month following 30 days of work)
• Two weeks paid parental leave
• Employer paid life insurance
• Employer paid short term and long term disability insurance

How to Apply:

You can submit through LinkedIn, but also go to our website directly at: /careers

Quality Whole Person Care is Wesley Family Services' service philosophy that aims to enhance the clinical care provided to individuals served while also helping to strengthen the way we support one another as colleagues. WFS has embedded QWPC practices which emphasize every person has value in all aspects of services and work-place culture.

Wesley Family Services is proud to be an Equal Opportunity Employer. xhyhwjd Our policies for both current and prospective employees prohibits discrimination on the basis of race, color, religious creed, disability, ancestry, national origin (including limited English proficiency), age, sex assigned at birth, sexual orientation, transgender identity, gender transition, gender identity, gender expression, military or veteran status.