What are the responsibilities and job description for the Eligibility Specialist position at Three Crosses Regional Hospital?
If you're looking for a place to call home and grow, Three Crosses Regional Hospital is looking for you! We are looking for an Eligibility Specialist that is committed to clinical excellence and building a patient-centered culture.
Three Crosses Regional Hospital is an advanced independent healthcare organization led by a local team of professionals dedicated to high quality patient care and being the first choice of patients and providers in the communities we serve.
We are dedicated to hiring team members that will adapt to our culture, pride themselves in professionalism, integrity, transparency, two-way communication, and ensuring the safety and well-being of our patients and staff.
Responsible for ensuring a streamline process for verifying insurance co-pays, coinsurance and other financial responsibilities before patient visits.
The incumbent will carry-out her/his duties by adhering to the highest standards of ethical and moral conduct, acts in the best interest of Three Crosses Regional Hospital, and fully supports the mission, vision, and values of Three Crosses Regional Hospital. The incumbent will have knowledge of health care systems, and have demonstrated ability to interact, relate to, work with, and support the activities of a diverse workforce.
Primary Responsibilities
- Verify insurance coverage, co-pays, and coinsurance and outstanding balances for patients across orthopedics, general surgery, plastics, GYN, and internal medicine.
- Process all assigned patient insurance verifications to meet all third party and/or company policies.
- Verifies all insurance intakes through various websites, Medicare system and phone/internet resources. Updates insurances in company computer system.
- Runs and verifies any changes to Medicaid, Medicare patient insurance coverage Files all completed verifications in an organized system.
- Demonstrated ability to establish and maintain effective working relationships with supervisors and co-workers
- Accurately document insurance details in a centralized spreadsheet to provide real-time access for front office personnel.
- Reduce the administrative burden on front desk staff, allowing them to focus on patient check-in and service.
- Improve billing accuracy, minimizing claim denials and patient confusion regarding financial responsibilities.
- Enhance workflow efficiency by proactively identifying and resolving insurance discrepancies before patient appointments.
- Attend staff meetings as needed.
- Other duties as assigned.
Education and Experience
- Required: High School diploma or equivalent.
- Required: Minimum 1 year related experience.
- Required: Meet all Employee Health Requirements.
“We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law”.
