Eligibility Verification Specialist

Eligibility Verification Specialist

The EV Specialist will be responsible for processing insurance eligibility verification for assigned provider clinics. Working through EHR systems, insurance portals, and by phone, employee will complete insurance verification and provide those details back to the clinics. Employee will also be responsible for managing the Quality Assurance for those accounts throughout the billing process.

Job Duties:

1. Work within the EHR to receive and manage insurance coverage and insurance required approvals.
2. Verify referral information is accurately entered into the EMR and notify specialty practice staff of any discrepancies.
3. Works together with other team members to achieve department goals.
4. Fulfills all compliance responsibilities related to the position.
5. Performs other duties as assigned by supervision.

Qualifications:

1. Education: High School Diploma or GED.
2. Training and Experience: Minimum of one-year job-related experience. Customer service experience. MS Office (Excel, Word). Experience with medical billing processes or healthcare practice preferred.
3. Job Knowledge: Must organize and manage multiple priorities; excellent interpersonal, communication and presentation skills. Strong team player and commitment to organizational values.

Essentials:

1. Must be able to report to work fit for duty and free of any adverse effects of illegal drugs, medical marijuana, prescription medication, and/or alcohol.
2. Must be able to effectively communicate both orally and in writing with other individuals.
3. Ability to solve problems with assigned tasks.

Physical Demands:

• Physical Effort: Duties involve sedentary to light physical effort. Physical demands range from sitting, walking, standing, or pushing or pulling materials. Work may involve exerting up to 10 pounds of force to lift, carry, push, pull or move objects.

Monday - Friday 8-5