Job Title: Patient Eligibility Specialist
Supervisor: Patient Accounts Manager Supervises: N/A
Salary Range: $31,138 to $44,395 ($14.97 - $21.35/hr)
Job Overview: This position is responsible for conducting patient insurance verifications prior to patient visit. Must be highly skilled in verbal communications and be capable of high-volume workloads. The Patient Eligibility Specialist will also be responsible for updating information in patient demographic with updated information from insurance companies and patients. New patient calls will be referred to the Patient Eligibility Specialist to gather patient insurance information so that it can be verified prior to the patient being seen.
Essential Functions (Major Duties or Responsibilities):
- Coordinator for the electronic eligibility system between the clearinghouse and the Electronic Medical Record system.
- Access multiple web portals to identify and verify eligibility and benefits for all patients with appointments, including the deductible and co-pay information prior to the appointment time.
- Input patients’ relevant data into Electronic Medical Records system.
- If patients’ insurance is no longer valid, contact patient for new information and/or educate patient on the sliding discount program and what is needed to bring in for qualification at the time of the visit.
- Verify demographic information on new patients and any patients with changes when they are on the phone.
- Become a Certified Application Counselor for the Affordable Care Act and assist patient in open enrollment periods with applications.
- Assist billing and collections personnel when needed as time permits.
- Assist in covering front desk personnel when needed for meetings etc.
- Participate in staff meetings and other meetings as instructed.
- Adhere to the Mission and Values of BCHC.
- Performs other duties as required and assigned.
Minimum Qualifications (Education and Experience): High school diploma or equivalent. One year minimum experience in eligibility and benefits preferred.
Knowledge, Skills and Abilities (KSA’s):
- Computer knowledge.
- Excellent customer service and communication skills.
- Ability to work as a team member.
- Manage multiple tasks simultaneously.
- Highly motivated and organized.
- Empathetic with patients’ needs and concerns.
- Understanding of insurance plan types, medical terminology, and basic billing processes.
- Ability to navigate insurance websites.
- Ability to work independently and complete tasks within the expected timeframe.
- Attention to detail and ability to complete the job with minimal errors.
- Experience with Microsoft Word, Excel, and Outlook (preferred).
- Experience using Microsoft Teams (preferred)
- The person in this position works a professional workweek and the incumbent’s flexibility to this work schedule is considered a condition of employment. It is understood that the hours of work may vary from day to day, week to week. The hiring manager will work with the incumbent to determine work schedule specifics.
- Ability to travel locally and occasionally out of town.
- Valid Montana Driver’s License, able to become part of Center’s insurance policy.
- Applicant must be fully vaccinated for Covid-19 or request and be granted a medical or religious exemption.
Physical and Environmental Demands: Work is performed in an office and clinic setting; stands, walks with intermittent sitting; reaches for and uses writing instruments and keyboard; reads reports and other written materials; extensive use of telephone and oral communication with the public and coworkers; stoops; bends; kneels; reaches for; picks up; and pushes or pulls; ability to lift up to 30 pounds.
Special Requirements: Performs duties in the deliverance of health services. Hazardous risks may include exposure to infected body fluids, sharp instruments and chemicals, requires adherence to universal safety precautions.