Eligibility and Benefit Specialist

Description

JOB TITLE: Eligibility and Benefit Specialist
LOCATION: Hybrid - Rockville
HOURS: 4 DAY WORK WEEK - Monday - Thursday (Full-Time)

*Spanish speaker preferred.

FREE PARKING AT ALL 7 OFFICE LOCATIONS!
 
BENEFITS:
Health/Dental/Vision Insurance - Cigna
FSA
HSA
Life Insurance
401K Contributions
Disability Insurance
Paid Time Off
Every Friday off
Tuition Assistance
Free Parking
Paid Maternity and Paternity Leave
STD/LTD/ADD Insurance (short-term disability, long-term disability and accidental death and dismemberment insurance)

GENERAL STATEMENT OF DUTIES:

Verifies insurance eligibility and benefit coverage for all scheduled patients. Answers patient questions regarding insurance benefits and cost-share. Assists patients with coordination of benefit related issues. Aids the Call Center and Front Desk with on demand eligibility inquiries.

SUPERVISION RECEIVED: Reports directly Call Center Managers and Director of Clinical Practices

SUPERVISION EXERCISED: None

TYPICAL PHYSICAL DEMANDS:

Requires sitting for long periods of time while working in an office environment. Requires visual ability that is correctable to 20/20. Some bending, lifting and stretching required. Works well under stress. Proper telephone etiquette is required. Good oral and written communication skills are required.

TYPICAL WORKING DEMANDS: Normal office environment.

EXAMPLES OF DUTIES: (This list may not include all duties assigned.)

1. Verify eligibility and benefits for all patients prior to their appointment and document status in patients’ chart
2. Contact patients when insurance on file is expired. Update insurance in the patient’s chart and notify appropriate departments of the change of insurance
3. Respond to patient inquiries for eligibility and benefit
4. Follow up with patients after their appointments for additional insurance information as needed
5. Ability to schedule and cancel appointments on NextGen software
6. Assist Call Center and Front Desk with eligibility and benefit questions
7. Ability to produce daily and weekly reports
8. Ability to utilize internet and telephone to communicate with insurance companies
9. Ability to utilize NextGen RTS and Phreesia to submit eligibility transactions
10. Perform other related work as required
11. Other Duties as Assigned: The assignment of duties to employees is not limited to the content of this job description. Other tasks and assignments may be related to the work usually assigned to the employee, but in some circumstances may be completely unrelated.

Performance Requirements: Knowledge, Skills and Abilities

1. Ability to read, understand, communicate, and follow oral and written instructions.
2. Knowledge of grammar, spelling and punctuation required.
3. Skills in operating a computer, photocopier, fax machine and postage meter needed Excellent interpersonal skills required.
4. Ability to establish and maintain effective working relationships with patients, employees, physicians and the public is a must.
5. Ability to work in a fast paced, stressful environment is required.
6. Ability to perform more than one task at a time is required.
7. Must be detail oriented.
8. Bilingual preferred.

COMPLIANCE:

1. Follows compliance requirements mandated by CMS, Medicare and all other ARA contracted carriers.
2. Follows HIPAA regulations for maintaining patient confidentiality and the handling of medical information.
3. Demonstrates a strong commitment to honest and responsible corporate conduct.
4. Identifies reports and/or prevents any fraudulent or unethical behavior.
5. Initiates notification to management if inappropriate behavior is observed within the organization.

HIPAA- Minimum Necessary Access to PHI

The responsibilities associated with this position allow access to the computer “role” of ARA as limited Call Center and Business Office employee (read only) and also for the purpose to Access ARA interoffice NextGen email.

We are committed to enforcing minimum necessary access to our patients’ PHI by limiting the uses and disclosures of this information within our practice.

In order for this employee to carry out his/her job in a manner that best serves our patients, the employee needs access to the mentioned computer “role”. Role descriptions are explicitly defined in our HIPAA manual.

Access to computer information is password protected. Upon termination of an employee, his/her password will be deleted from the system.

EDUCATION:

Minimum requirement: High School Diploma

EXPERIENCE:

Two years medical office front desk requirement needed, preferably in a Call Center or insurance verification specialist role.

DISCLAIMER:

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

Qualifications