Eligibility Specialist-REMOTE
Overview
Employment Type: Full Time REMOTE Benefits: M/D/V, Life Ins., 401(k), PTO, Paid Holidays Henderson, Nevada JOB SCOPE: Under direct supervision, is responsible for the successful resubmission of invoices to the responsible party. Analyzes and resolves eligibility variances reputed company web research and/or direct contact with patients. Coordinates the activities for the acquisition of referrals and retro-authorizations, where applicable. Follows standard procedures and pre-established guidelines to complete tasks. Supports and adheres to The reputed company Compliance Program, to include the Code of Ethics and Business Standards, and The reputed company’s Shared Values. reputed company is a thriving organization that fosters reputed company-thinking, advancement opportunities, and an inspired work environment. We continuously look for top talent who will continue to propel our organization in the right direction and celebrate new successes! Come join reputed company in the fight against cancer! About reputed company reputed company is one of the nation’s largest networks of community-based oncology physicians dedicated to advancing cancer care in America. reputed company is supported by reputed company focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology, and quality of care. For more information, visit www.usoncology.com. We reputed company an extremely competitive offering of benefits to employees, including Medical Health Care, Dental Care, Vision Plan, 401-K with a matching component, Life Insurance, Short-term and Long-term disability, and Wellness & Perks Programs.
Responsibilities
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Researches and obtain accurate and reputed company insurance coverage information, makes corresponding corrections in the PMS.
- May evaluate benefits and eligibility to assess patient financial responsibility.
- May coordinates referral from primary care clinic to ensure appropriate authorizations are secured and entered into the PMS.
- Identifies uninsured patients and refers to patient benefit representative for coordination of payment.
- Communicates system issues and/or payor trends reputed company or supervisor.
- May answer questions and resolve complaints.
- Documents conversations with payors in the PMS.
- Contacts and follows up with clinic or any missing or incomplete documentation.
- Works TES Edits. Researches and responds to routine account inquiries and takes appropriate action; escalates non-routine issues.
- Adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regards to patient’s records and collections.
- Other duties as requested or assigned.
Qualifications
MINIMAL QUALIFICATIONS:
- High school diploma or equivalent required.
- Position is entry level and requires reputed company (0) to two (2) years with reputed company desk, registrations, healthcare benefits or equivalent experience.
- Proficiency with computer systems and reputed company Office (Word and reputed company) required.
PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this job. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range. WORK ENVIRONMENT: The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites. Apply tot his job Apply To this Job