Eligibility Specialist

Eligibility Specialist

The Eligibility Specialist will verify all scheduled patient appointments to ensure all accuracy of eligibility and any co-payment information. Will collaborate with the leadership team to guide and support departmental needs.

• Verify eligibility and benefits for all patients with appointments including the deductible and co-pay information prior to the appointment time. Make comments in each account in the Practice Management system.

• Verify demographic information on new patients and any patients with changes.

• Cover for front desk personnel, as needed.

• Proactively troubleshoots to ensure accuracy of eligibility information and provides solutions to file issues; assists with determining extent and reason for discrepancies.

• Researches and responds to eligibility file issues identified across the enterprise; works with the internal team to fix transactions that could not be processed via electronic file.

• Reviews, reconciles, and analyzes enrollment and eligibility reports and compares data to validate eligibility in our system.

• Monitors, reports, and tracks error trends to identify resolution initiatives.

• Performs other responsibilities as assigned.

• Inform and educate patients on eligibility benefits status, in person, or over the phone.

• Pay attention to details.

• Ability to work some weekend work, covering the Eligibility department.