Neighborhood Healthcare
- Escondido, CA
- Permanent
- Full-time
As a personal, non-profit 501( C) (3) neighborhood health company, we serve over 350 k medical, oral, and behavioral health check outs from more than 77 k individuals every year. We do this in pursuit of our objective to enhance the health and joy of the neighborhoods we serve by supplying quality care to all, despite circumstance or scenario.
We have actually been doing this considering that 1969 and it is our staff members that make this objective a truth. Despite the function, our group concentrates on being thoughtful, having stability, being expert, constantly working together, and regularly exceeding and beyond. If that seems like a company you wish to belong of, we would like to have you.
Under the instructions of the Revenue Cycle Supervisor, the Billing Eligibility Specialist, is accountable for keeping everyday and regular monthly eligibility confirmation and paperwork for all clients with Neighborhood Healthcare. Accountable for market and insurance coverage updates. Verifies insurance coverage eligibility. Functions with clients to solve billing and insurance coverage associated problems, PCP modifications, carries out batch and specific eligibility confirmation using the Insurance Eligibility (IE) function in eCW. This position might have a choice to work remote and is based upon service requirements.
ESSENTIAL DUTIES/RESPONSIBILITIES:
- Complete insurance coverage confirmation 1-2 day prior and location electronic notes in eCW precisely and prompt.
- Performs batch and specific eligibility confirmation making use of the Insurance Eligibility (IE) function in eCW
- Submit electronic insurance coverage confirmation through eCW, insurance coverage site portals or call insurance provider to ask about eligibility, advantages info, and payment for services.
- Maintain understanding of all contracted insurance coverages and programs accepted at Neighborhood Healthcare
- Provide direct assistance to centers relating to eligibility queries
- Ensure precise insurance coverage eligibility, advantages and monetary details required for billing and collection procedures.
- Ability to finish a high volume of advantage confirmation demands
- Perform PCP modifications by starting 3 -method calls with client and insurance coverage strategies
- Inform clients if required of their advantages and monetary duty.
- Work carefully with websites, insurance coverage provider and clients.
- Apply Sliding Fee Discount Program (SFDP) discount rates as needed. Make sure Declaration of earnings paperwork has actually been caught.
- Provide customer care internally and externally with professionalism, courtesy, understanding, and follow through.
- Function at greatest level according to eligibility proficiency
- Meets day-to-day performance requirements
- Maintain the privacy of client info in accordance with business policy & treatment, and HIPAA guidelines
- Participate in numerous tasks and/ or conferences and total other job designated by management.
- Other duties/projects as designated
Requirements
Education: High School Diploma or comparable needed. An accreditation from a recognized school or college with focus on medical front workplace abilities chosen.
Experience: Minimum of 2 years’ work experience in associated position needed. Medical Receptionist experience dealing with insurance coverage eligibility chosen. Need to have a basic understanding of medical workplace treatments and billing insurance coverage providers consisting of Medicare and Medicaid. Experience dealing with an electronic health record system needed; ideally ECW. Prospect needs to have exceptional interaction and organizational abilities Multiple specializeds and/or FQHC/community center environment experience a plus. A well-rounded understanding of insurance coverage eligibility procedures and protection standards for numerous providers.
Skills: Bilingual (English/Spanish) chosen. Attention to information and precision; encouraged self-starter. Capability to work effectively in a hectic environment. Crucial thinking abilities to evaluate and fix complicated client account. Exceptional customer care abilities needed and capability to deal with tight spots.
Neighborhood Healthcare needs workers to be totally immunized (consisting of a booster dosage) versus COVID-1 and show evidence of vaccination/booster upon hire or get approval for an exemption based upon a medical factor, special needs or faith. Evidence of booster dosage will rest upon booster eligibility.
Neighborhood Healthcare
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