Eligibility Specialist

SCP Health; Lafayette (LA); On-site; USD 21,000 - 29,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k) with company match

Paid time off

Holidays

Professional development support

Employee wellness resources

Job summary

SCP Health is seeking an Eligibility Specialist to resolve demographic and insurance edits and support PreBilling processes. You will update patient data, determine carriers, and verify information with payors or internal resources. The role emphasizes accuracy, teamwork, and adherence to department policies.

The position operates within Centricity-based workflows and requires strong data entry, communication, and problem-solving skills in a fast-paced setting.

Qualifications

• Detail oriented and organized.
• Self-motivated with data tracking to meet deadlines.
• Excellent interpersonal and communication skills.
• Proficient in Word, Excel, Windows and Outlook.
• Experience with data entry for extended periods.

Responsibilities

• Update demographics and/or insurance information based on feedback from internal or payor edits.
• Determine the appropriate insurance carrier and billing information from the patient record.
• Contact insurance carriers to verify data when data is insufficient or questionable.
• Utilize Centricity or payor websites to obtain accurate patient information.
• Request additional insurance entries in Centricity when necessary.
• Refer to supervisor for direction to ensure accurate resolution of edits.
• Identify and report system issues impacting billing quality.
• Promote teamwork to support department goals and quality.
• Participate in meetings and training to improve performance.

Skills

Detail oriented

Organized

Interpersonal skills

Communication

Team player

Tools

Centricity

Excel

Word

Outlook

Windows OS

Job description

At SCP Health, what you do mattersAs part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care.Why you will love working here:- Strong track record of providing excellent work/life balance.- Comprehensive benefits package and competitive compensation.- Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect.The Eligibility Specialist is responsible for accurately resolving registration and eligibility edits, related to the demographic and/or insurance information, based on departmental policies and procedures and feedback received from various payors. This person assists chart flow through the PreBilling processes and maintain inventory levels to ensure timely, effective and accurate chart processing while maximizing revenue.Responsibilities:Update demographics and/or insurance information based on feedback provided by internal or payor edits, using available resources: face sheets, insurance cards, eligibility results etc.Determine the appropriate insurance carrier and billing information from the data contained in the patient’s medical record and use that information to accurately update a patient’s account in the billing systemWhen insufficient or questionable data is supplied in the medical record, contact the appropriate insurance carrier or facility to acquire accurate dataUtilize the Eligibility process/data in Centricity or on the payors’ websites to obtain more accurate information on each patient returned with an editRequest additional insurance company entries in Centricity when necessaryRequest direction and clarification from supervisor or lead when necessary, in order to assure accurate resolution of editsIdentify and work complex edits presented from various sourcesIdentify and report results of user and/or system issues that impact billing qualityMaintain understanding of current departmental policies and proceduresPromote a team environment that will support the growth of every department member and achievement of all department goals as a result of team workActively participate in meetings and educational programs in an effort to improve both individual and team quality and effectivenessKnowledge, Skills and Abilities:Detail oriented and organizedSelf-motivated; capable of compiling/tracking data to meet deadlines and goalsExcellent interpersonal skillsAbility to work equally well individually and in a team environmentProfessional attitude and demeanorWritten and oral communication skillsProficient computer knowledge of Word, Excel, Windows and OutlookQuick learner with an aptitude for custom computer systemsPrevious success and comfort with entering data for extended time periods and limited interruptionsPay Range:15.00 - 21.00 USD per hourThis range represents the anticipated base salary for this role. Actual compensation will be determined based on experience, qualifications, and internal equity considerations.-We offer a comprehensive benefits package designed to support your health, financial well-being, and work-life balance, including medical dental, vision insurance, a 401(k) plan with a company match, paid time off and holidays, professional development support, and employee wellness resources.Visit our website for further information. https://myscpbenefits.com/Login name: corp-guestPassword: weheal