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.