Insurance AR/Eligibility Specialist

job
  • Patient Financial Concepts
Job Summary
Location
Thomaston ,GA
Job Type
Contract
Visa
Any Valid Visa
Salary
PayRate
Qualification
BCA
Experience
2Years - 10Years
Posted
04 Feb 2025
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Job Description
Responsibilities include, but are not limited to:
  • Interview patients/family members (in-person/phone) to determine eligibility based on client guidelines and HIPAA regulations.
  • Assist with applications for state, county, or government programs, ensuring all necessary documentation is collected.
  • Submit completed applications for approval and follow up as needed.
  • Ensure compliance with hospital, company, and departmental policies and procedures.
  • Maintain daily contact with hospital departments and external entities regarding self-pay referrals.
  • Maintain accurate financial records, including statistical data.
  • Create detailed notes in the hospital or host system reflecting account actions.
  • Initiate Presumptive Eligibility (PE) for Medicaid eligibility.
  • Complete tasks within established timeframes and attend departmental meetings/training.
Additional Duties:
  • Proficient in EMR and charge posting; submit clean claims electronically and maintain clearinghouse reports.
  • Verify patient eligibility, resolve insurance denials, and submit secondary claims/appeals as needed.
  • Address deductible, co-insurance, and co-pay questions and recommend coding changes.
  • Perform soft collections and scrub Aged Trial Balance Reports for insurance discrepancies.
  • Train team members and assist with internal audits.
  • Review Denial Reports, update accounts, and generate bad debt and Medicaid eligible reports.
  • Other duties as assigned.
Benefits:
  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Health insurance
  • Paid time off
  • Paid training
  • Tuition reimbursement
  • Vision insurance
Requirements
  • High school diploma or GED, minimum requirement
  • Strong communication, including writing, speaking and active listening
  • Great customer service skills, including interpersonal conversation, patience and empathy
  • Good problem-solving and critical thinking skills
  • Ability to multi-task and work in a hospital environment
  • Organization, time management and prioritization abilities
  • Understanding of industry-specific policies, such as HIPAA regulations for health care is helpful
  • Attention to detail and excellent quality
  • Proficient computer skills, Microsoft Office; working knowledge of billing software, electronic medical records (EMR) or hospital software systems is a plus
Physical Requirements:
  • Team members are required to sit for an extended period, occasionally lift supplies/equipment, and move up to 25 pounds.
  • Must travel for onsite work, training and attend client meetings as needed.
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