Eligibility Screener- Escondido, CA

ARStrat LLC; Escondido (CA); Hybrid; USD 28,000 - 39,000; Full time

Benefits offered by this job

Comprehensive Health Benefits

Life & Disability Coverage

401(k) Retirement Plan

Paid Time Off

Flexible Benefit Options

Job summary

GetixHealth is seeking an Eligibility Screener to verify patient insurance coverage, review financial and demographic data, and determine eligibility for healthcare benefits. This role collaborates with patients, insurers, and hospital systems to ensure accuracy before services are provided, helping reduce billing issues.

Responsibilities include insurance verification, patient communication, data entry, HIPAA compliance, and thorough documentation.

Qualifications

• High School diploma or GED required or equivalent experience.
• 1 year healthcare coverage/eligibility experience preferred.
• Proficient PC skills including Microsoft Office.
• Ability to maintain the highest level of confidentiality.
• Excellent interpersonal, written, and oral communication skills.
• Willing to work inside of a hospital including visiting hospital rooms to complete tasks.
• Ability to work in a team fostered environment.
• Ability to multitask and prioritize work.
• Ability to adapt to a flexible schedule.
• Office environment within a local hospital
• Ability to lift and/or move 20 pounds with or without accommodation.
• Heavy walking is required.

Responsibilities

• Verify insurance coverage, determine eligibility for third-party resources.
• Maintain patient communication and documentation in appropriate systems.
• Retrieve and forward requested records and information to appropriate parties.
• Analyze, distribute, and follow-up on special requests and adjustments with hospital personnel.
• Educate patients on eligibility requirements and the application process.
• Maintain professional relationships with patients and governmental agencies to ensure cooperation and compliance.
• Document pertinent patient information and all work activity.
• Ensure accounts are processed per eligibility program standards and regulations.
• Perform other duties as assigned by management.

Skills

Interpersonal communication

Confidentiality

Microsoft Office

Teamwork

Detail oriented

Education

High School diploma or GED

Tools

Microsoft Office Suite

Job description

An Eligibility Screener is responsible for verifying patient insurance coverage, reviewing financial and demographic information, and determining eligibility for healthcare benefits or assistance programs. This role works directly with patients, insurance companies, and healthcare systems to ensure accurate information is obtained prior to services being provided, helping reduce billing issues and claim denials. Responsibilities include insurance verification, patient communication, documentation, data entry, and maintaining compliance with HIPAA and company policies.

If you are a caring, compassionate individual with a sense of community, we have a rewarding career available for you.

• Do you want to help those within need in your community?
• Would you be interested in assisting healthcare patients to find insurance to assist with their medical bills?
• Work in a local hospital assisting patients with applications for third-party resources including state aide.

Compensation: $24.00/hr + Quarterly Bonus Eligible

Work shift: Tuesday - Saturday 8:00am - 5:00pm PST

• 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.

Requirements:

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.
• Excellent interpersonal, written, and oral communication skills.
• Willing to work inside of a hospital including visiting hospital rooms to complete tasks
• 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.
• Office environment within a local hospital
• Ability to lift and/or move 20 pounds with or without accommodation.
• Heavy walking is required

Why Join GetixHealth?

Founded in 1992, GetixHealth is a trusted leader in healthcare revenue cycle management, with offices across the U.S. and India. We’re more than revenue cycle experts—we’re a mission-driven team dedicated to helping healthcare organizations improve financial outcomes while delivering compassionate care. With over 2,500 employees, we foster a culture that values professionalism, innovation, and—above all—people.

Benefits & Incentives:

• Comprehensive Health Benefits: Choose from a variety of medical, dental, and vision plans designed to support your overall well-being.
• Life & Disability Coverage: Receive company-paid Basic Life and AD&D insurance, short-term and long-term disability coverage, with the option to purchase additional voluntary Life and AD&D benefits.
• 401(k) Retirement Plan: Become eligible to participate in the company's 401(k) plan on the first day of the quarter following three months of continuous employment, with a company match to help you invest in your future.
• Paid Time Off: Begin accruing PTO on your first day of employment, promoting a healthy work-life balance from the start.
• Flexible Benefit Options: Tailor your benefits package with a variety of options to meet your individual and family needs.

GETIXHEALTH IS AN EQUAL OPPORTUNITY EMPLOYER

Note: This job description is not intended to be an exhaustive list of responsibilities or qualifications and may be subject to change based on business needs.

Education

High School or better.

Experience

1 year: Healthcare Customer Service

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.