Eligibility Specialist - Ambulatory Finance

Valleywise Health; Phoenix (AZ); On-site; USD 26,000 - 39,000; Full time

Job summary

Valleywise Health in Phoenix seeks an Eligibility Specialist for Ambulatory Finance. You will screen patients for self-pay financial assistance and gather documentation, entering data into multiple systems.

Responsibilities include verifying insurance, assisting with AHCCCS applications, tracking submissions, and performing quality checks to ensure accurate billing and reimbursement.

Qualifications

• Requires a high school diploma or GED.
• Minimum of two years of interviewing/investigative experience related to AHCCCS applications.
• Must have valid fingerprint clearance card or complete Affidavit at hire; obtain card within 7 days; present card within 90 days.

Responsibilities

• Screen patients for self-pay financial assistance.
• Gather documentation and enter information into multiple systems.
• Ensure compliance with policies and monitor processing of all accounts; register patients.
• Verify insurance and AHCCCS eligibility.
• Initiate and assist patients in completing the AHCCCS application; track completion.
• Perform quality checks on AHCCCS applications and ensure timely processing.
• Collaborate with management to identify and resolve issues affecting billing.

Skills

Data entry

Typing speed 30 wpm

10-key by touch

Math skills

Interviews/investigative experience

Verbal & written communication

AHCCCS application knowledge

Multitasking

Education

High school diploma or GED

Job description

Eligibility Specialist - Ambulatory Finance

Under the direction of the Director of Patient Access, this position ensures that patients receiving services from Valleywise Health have been properly screened for self-pay financial assistance. This position is responsible for gathering thorough documentation and entering information into various systems. This position ensures that all compliance policies are monitored and followed. Ensures accurate and timely processing of all accounts as well as registers patients while ensuring accurate and timely processing of all accounts. This position obtains necessary verification of insurance and other eligibility programs. Initiates and assists patients in completing the AHCCCS application. Tracks and monitors the completion of the AHCCCS application. Performs quality checks on all eligibility/AHCCCS applications initiated in the department and ensures they are processed on every self-pay or unverifiable payer source. Also performs quality assurance checks on the AHCCCS application program and works with management and other staff to identify and resolve issues that threaten billing and reimbursement.

Hourly Pay Rate: $18.97 - $27.98

Qualifications

Education :

Requires a high school diplomaorGED.

Experience:

Must have a minimum of two (2) years of progressively responsible interviewing/investigative experience in obtaining confidential information and direct experience with the AHCCCS application process that demonstrates an understanding of the required knowledge, skills, and abilities.

Certification/Licensure:

Must have a valid fingerprint clearance card issued by the Arizona Department of Public Safetyorsubmit a completed Affidavit at the time of hire. Must complete fingerprint clearance card application within seven (7) days of hire date. Must present actual card within 90 days of applying for a fingerprint clearance card.

Knowledge, Skills, and Abilities:

Requires excellent data entry skills including, 10-key by touch, and the ability to type 30 words per minute accurately.

Basic math skills are required.

Must be able to demonstrate interviewing and investigative techniques in order to obtain information that may not be offered.

Must possess good interpersonal and communication skills both verbally and in writing including knowledge of basic grammar, spelling & punctuation.

Requires the ability to read, write and speak effectively in English.

Must be able to handle multiple tasks simultaneously.

Insurance verification and Medicaid eligibility experience are highly desirable.

Critical thinking skills are strongly preferred.