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  • Insurance Eligibility Specialist

    Posted: 01/09/2022

    A well-established medical practice in Bluffton is hiring for an Insurance Eligibility Specialist. This is a temp-to-hire, full-time opportunity.

    Essential Duties and Responsibilities:

    • Reviews clinic schedules 48 hours in advance of appointment for designated locations and checks all eligibility and benefits to ensure patient insurance is active.
    • Will be required to contact patient if there is an issue with their insurance in advance of the appointment.
    • Updates copay information in Athena and provides notes in the patient account for the front desk regarding co-insurance, deductibles due and collections of any balances due prior to patient’s appointment.
    • Monitors eligibility bucket in EMR for upcoming appointments.
    • Reviews the patient’s insurance for eligibility and benefits.
    • Responsible for ongoing daily monitoring of EBT email group to assist Patient Access Coordinators with eligibility issues identified at the time of making the appointments.
    • Verifying that authorizations are obtained and attached to the appropriate appointment at the time of the visit to ensure claim is submitted correctly and accurately.

    Education and/or Experience:

    • High school diploma or general education degree (GED).
    • Associate Degree desired.
    • Minimum two years of medical billing and/or eligibility experience.
    • Knowledge of ICD9, CPT, HCPCS and the use of modifiers preferred.
    • Familiar with CMS 1500 claim form completion, knowledge of Medicare,
    • Managed care and commercial insurance products and plans.
    • Knowledge of physician billing and/or collections.
    • Typing speed 55 wpm and the ability to use a calculator.

    New Group Name: Full Time

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