What are the responsibilities and job description for the Insurance AR/Eligibility Specialist position at Patient Financial Concepts, Inc?
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.
Keep a pulse on the job market with advanced job matching technology.
If your compensation planning software is too rigid to deploy winning incentive strategies, it’s time to find an adaptable solution.
Compensation Planning
Enhance your organization's compensation strategy with salary data sets that HR and team managers can use to pay your staff right.
Surveys & Data Sets
What is the career path for a Insurance AR/Eligibility Specialist?
Sign up to receive alerts about other jobs on the Insurance AR/Eligibility Specialist career path by checking the boxes next to the positions that interest you.
