Patient Enrollment Specialist

Job Description

Job Description

Job Title

Patient Enrollment Specialist

Reports to

Billing & Coding Manager

Summary of Responsibilities

Enroll patients into programs to assist in administration and medications injected by physicians

Lists of Responsibilities / Duties are as follows but not limited to

• Enroll patients into programs that assist patients in covering costs of injectable drugs
• Maintains active communication within billing department of changes in program eligibility requirements
• Coordinate with clinical staff to ensure proper documentation is required for enrollment
• File appeals to programs to obtain additional funding when needed
• Stays up to date of program requirements and eligibility requirements
• Submit claims to programs for payments
• Follow-up on denials and non-payments
• Submit refund requests to programs when required
• Submit claims to management for write offs as needed

Minimum Education Requirements

High School Diploma, required

Minimum Background Requirements

Two years of medical related experience with knowledge of diagnosis codes (ICD10), procedure codes (CPT), injectable drug code (HCPCs). Healthcare insurance knowledge and billing requirements knowledge and experience is necessary

Minimum Demonstrated Skills

The American with Disabilities Act requires that reasonable accommodations be made for qualified individuals to help perform the required duties and tasks of the position. Please let us know at the time you apply for a position if you will need any special accommodations.

TYPICAL PHYSICAL DEMANDS : Work may require sitting for long periods of time; also stooping, bending, and stretching for files and supplies. Occasionally lifting files or paper weighing up to 30 pounds. Requires manual dexterity sufficient to operate a keyboard, operates a calculator, telephone, copier, and other office equipment as necessary. It is necessary to view and type on computer screens for long periods.

TYPICAL WORKING CONDITIONS : Work is performed in an office environment. Work involves frequent contact with staff members, physicians, and the public. Work may be stressful at times. Interaction with others is constant and interruptive. Occasional evening or weekend work as needed.

SERA reserves the right to revise or change job duties and responsibilities as the need arises. This job description does not constitute a written or implied contract of employment.

HIPAA : All employees are required to adhere to the SERA privacy practices as documented in the SERA Employee Handbook and all SERA HIPAA policies and procedures. Failure to comply may result in disciplinary action ranging from a warning to termination depending on the level of violation.

This description provides only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve. It is not intended to be all-inclusive. The employee may be required to perform other reasonably related business duties as assigned.