Eligibility Consultant

Description:

• Follows processes to assist with processing, insurance verification and authorization, revenue cycle management, compliance and documentation, as well as customer service and issue resolution.
• Provides support in ensuring accurate billing, efficient revenue flow, and compliance with regulations.
• Handles physical documents and paper records to verify the eligibility of patients or members for healthcare services.
• Reviews paper forms, applications, or supporting documentation to gather and validate information such as insurance coverage, demographic data, and eligibility criteria.
• Organizes paper-based eligibility documents by reading and maintaining filing systems, ensuring proper document storage, and implementing strategies to improve accessibility and retrieval of information.
• Analyzes the paper-based information and documentation to determine the eligibility of patients or members for healthcare services.
• Performs manual data entry tasks to input eligibility information into relevant systems or databases.
• Ensures compliance with relevant healthcare regulations, policies, and industry standards in relation to paper-based eligibility operations in order to maintain patient confidentiality.
• Identifies opportunities to enhance the efficiency and accuracy of paper-based eligibility operations.
• Follows regular, timely feedback as well as the formal performance review process to ensure delivery of exceptional services and engagement, motivation, and personal development.
• Generates reports and analyzes data related to paper-based eligibility operations to help improve processes, address bottlenecks, and support decision-making.

Requirements:

• Less than 1 year work experience
• Working knowledge of problem solving and decision making skills
• High school diploma or equivalent required

Benefits:

• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs including wellness screenings, tobacco cessation, weight management programs, counseling and financial coaching
• Paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility

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