Eligibility Specialist

TSG Resources, Inc.; United States; On-site; USD 18,000 - 26,000; Full time

Benefits offered by this job

Medical insurance

401(k) plan with company match

Paid time off

Job summary

SCP Health is seeking a detail‑oriented billing support professional to update patient demographics and insurance data. You will determine carriers, verify data in Centricity, and contact payors when data is incomplete, contributing to accurate patient billing records.

Join a collaborative team with a strong work‑life balance and comprehensive benefits. The role emphasizes data accuracy, timely updates, and cross‑functional communication within a healthcare environment.

Qualifications

• Detail oriented and organized.
• Self-motivated with data tracking skills.
• Excellent interpersonal skills.
• Ability to work well individually and in a team.
• Professional attitude and demeanor.
• Strong written and oral communication.
• Proficient in Word, Excel, Windows and Outlook.
• Fast learner with adaptable data entry.
• Experience entering data with limited interruptions.

Responsibilities

• Update demographics and insurance information from payor edits using available resources.
• Determine appropriate insurance carrier and billing information from medical records to update accounts.
• Contact insurance carriers or facilities when data is insufficient.
• Use Centricity or payor sites to verify data for edits.
• Request additional insurance entries in Centricity when needed.
• Seek guidance from supervisor to ensure accuracy of edits.
• Identify and resolve complex edits from various sources.
• Report issues impacting billing quality.
• Maintain knowledge of departmental policies and procedures.
• Promote teamwork to achieve department goals and improve quality.

Skills

Detail oriented

Organized

Self-motivated

Interpersonal skills

Teamwork

Professional demeanor

Written and verbal communication

MS Word/Excel/Outlook

Data entry

Tools

Centricity

Job description

At SCP Health, what you do matters As 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.

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 system.
• When insufficient or questionable data is supplied in the medical record, contact the appropriate insurance carrier or facility to acquire accurate data.
• Utilize the Eligibility process/data in Centricity or on the payors’ websites to obtain more accurate information on each patient returned with an edit.
• Request additional insurance company entries in Centricity when necessary.
• Request direction and clarification from supervisor or lead when necessary, in order to assure accurate resolution of edits.
• Identify and work complex edits presented from various sources.
• Identify and report results of user and/or system issues that impact billing quality.
• Maintain understanding of current departmental policies and procedures.
• Promote a team environment that will support the growth of every department member and achievement of all department goals as a result of team work.
• Actively participate in meetings and educational programs in an effort to improve both individual and team quality and effectiveness.

Knowledge, Skills and Abilities:

• Detail oriented and organized.
• Self-motivated; capable of compiling/tracking data to meet deadlines and goals.
• Excellent interpersonal skills.
• Ability to work equally well individually and in a team environment.
• Professional attitude and demeanor.
• Written and oral communication skills.
• Proficient computer knowledge of Word, Excel, Windows and Outlook.
• Quick learner with an aptitude for custom computer systems.
• Previous success and comfort with entering data for extended time periods and limited interruptions.

Pay Range: 13.00 - 19.00 USD per hour This 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.

Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.