Eligibility Specialist (51598)

HealthLinc; Valparaiso (IN); On-site; USD 34,000 - 46,000; Full time

Job summary

HealthLinc in Valparaiso, IN is seeking an Eligibility Specialist to verify insurance eligibility and perform schedule preparation to ensure accuracy of coverage prior to patient appointments.

This role partners with the billing team, Patient Service Reps, and clinics to confirm benefits, request explanations of benefits when needed, and update patient charts for compliant care delivery.

Qualifications

• High school diploma or equivalent required.
• Minimum one year experience with eligibility.
• Experience with interpreting explanations of benefits preferred.
• Experience with medical terminology preferred.

Responsibilities

• Verify eligibility for patients prior to appointments.
• Communicate issues to the billing department as they arise.
• Verify if a patient is due for a specialty service before the appointment.
• Check all insurance details for accuracy.
• Review and update patients’ insurance prior to appointment.
• Import documentation into patients’ charts.
• Call insurance companies to verify coverage when needed.
• Collaborate with Patient Service Reps to collect required documents.
• Address Third Party Liability (TPL) updates.
• Perform tasks in a timely manner.
• Contribute to PCMH quality initiatives.

Skills

Customer service

Written communication

Verbal communication

Teamwork

Time management

Adaptability

Organization

Education

High school diploma

Tools

Intergy

FSSA

Insurance portals

Microsoft Office

EHR

Job description

Job DetailsJob Location: Corporate - Valparaiso, IN 46383Position Type: Full TimeEducation Level: High SchoolTravel Percentage: NoneJob Shift: DayAs an Eligibility Specialist, you will be verifying insurance eligibility and performing schedule preparation to ensure the accuracy of insurance prior to patients’ appointments.

Job Responsibilities

• Verify Eligibility.


• Communicate issues to the billing department as they arise.


• Verify if a patient is due for a specialty service prior to their appointment.


• Check all insurance details to ensure accuracy of insurance.


• Review and update patients’ insurance the day or day(s) prior to their appointment.


• Import necessary documentation into the patients’ charts.


• Call insurance companies to verify insurance coverage as needed.


• Work closely with Patient Service Reps to collect necessary documentation at the clinic.


• Work on Third Party Liability (TPL) updates.


• Works Tasks in a Timely manner.


• All HealthLinc staff is committed to engage in quality improvement initiatives that align with and support Patient-Centered Medical Home (PCMH).

QualificationsREQUIRED QUALIFICATIONS:

Education/Training

• High school diploma or equivalent

Experience

• Minimum one year experience working with eligibility


• Patient Service Representative, Billing, Intake Coordinator or Outreach experience highly preferred


• Experience with interpreting Explanation of Benefits highly preferred


• Experience with medical terminology highly preferred

Skills/Job Requirement

• Working knowledge of Intergy, FSSA, and insurance portals


• Customer service skills


• Written and verbal communication skills


• Proven ability to work in a team environment, as well as independently


• Ability to remain flexible and teachable


• Strong organizational and time management skills

Technology Skills

• Operate a multi-line phone system and other office equipment including printers, fax machines, etc.


• Basic software skills (Microsoft Office, EHR, online sources, etc.)