Eligibility Specialist – GetixHealth – Morgantown, WV

GetixHealth

$15 an hour

Principal Responsibilities

  • Maintain the appropriate level of work activity according to work standards and establish work processes to ensure timely certification for eligibility programs.
  • Retrieve and forward requested records and information, including medical records, insurance policy information, remittance advice, and itemized statements, to appropriate parties.
  • Analyze, distribute, and follow-up on special requests and adjustments with hospital personnel.
  • Maintain consistent proactive communication with the patient or patient representative throughout the eligibility process, keeping the patient informed of the account progress.
  • Screen patients and/or patient representatives to determine potential eligibility for Third Party resources.
  • Communicate effectively with physicians, case managers, social workers, and hospital business office staff on a daily basis to ensure questions are answered and issues are addressed.
  • Educate patients and patient representatives of the eligibility requirements, application process, and verification requirements for applicable programs.
  • Maintain a professional relationship with the patient and governmental agencies to ensure cooperation and compliance.
  • Document pertinent patient information and all work activity in the appropriate systems dictated by company policies and procedures.
  • Ensure accounts are processed in accordance to Eligibility Program standards, Client expectations, and all applicable federal and state regulations guidelines.
  • Responsible for understanding and complying with all policies, procedures, and regulations relating to job duties. Perform other duties as assigned by management.
  • High School Diploma or General Educational Development (GED) certificate or equivalent in relevant work experience desired.
  • Previous healthcare coverage/eligibility experience preferred.
  • Proficient personal computer skills including Microsoft Office.
  • Ability to maintain the highest level of confidentiality.
  • Bilingual (Spanish) a plus.
  • Excellent interpersonal, written, and oral communication skills.
  • Ability to work in a team fostered environment.
  • Ability to work in a multi-tasked environment.
  • Ability to prioritize and organize work.
  • Ability to adapt to a flexible schedule.

Work Environment

  • Office environment.
  • Ability to lift and/or move 20 pounds with or without accommodation.
  • Walking is required

We provide Equal Employment Opportunity for all individuals regardless of race, color, religion, gender, age, national origin, marital status, sexual orientation, gender identity, status as a protected veteran, genetic information, status as a qualified individual with a disability and any other basis protected by federal, state or local laws.

Job Type: Full-time

Salary: $15.00 /hour

Education:

  • High school or equivalent (Required)

Location:

  • Morgantown, WV (Preferred)

Language:

  • Spanish (Preferred)

Source:  

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