Healthcare Eligibility & Authorization Specialist

Wesley Family Services; Pittsburgh (Allegheny County); Vor Ort; USD 42.000 - 66.000; Vollzeit

Benefits dieser Stelle

Tuition discounts

Annual evaluations with pay increase

Employee Assistance Program

Free licensure supervision

Wellness Center

myStrength

Insurance discounts

Zusammenfassung

Wesley Family Services in Pittsburgh, PA is seeking an Eligibility Specialist to join the Finance team. You will handle authorization of services, pre-billing activities, and employee credentialing for all payers, ensuring accuracy of client eligibility and authorization status.

The role requires attention to detail, administrative support experience in healthcare, and proficiency with Microsoft Office. You will regularly coordinate with payers, process authorizations, and maintain compliance

Qualifikationen

• Minimum of a high school diploma or GED; Human Services or Business certificate or degree preferred.
• 3 years of administrative support experience in medical office or human services field and 3 years advanced level experience with Microsoft Office applications (Word, PowerPoint, Excel, Access, Outlook).
• PA Child Abuse, PA Criminal, and FBI Background Clearances obtained prior to start.

Aufgaben

• Runs eMedical daily for assigned programs.
• Updates electronic medical record (EMR) with insurance changes.
• Updates and enters authorizations and re-authorizations into EMR timely.
• Reviews plans and ensures commercial insurance is maintained throughout consumer treatment, updates EMR as needed to ensure correct billing.
• Follows close out procedures.
• Responsible for ACT 62 compliance as applicable to individual consumers.
• Manages the pre-closing report to make sure that all active clients are receiving services.

Kenntnisse

Administrative support

Detail oriented

Payer coordination

Ausbildung

High school diploma or GED

Human Services certificate

Business certificate or degree

Tools

Microsoft Office

Jobbeschreibung

Wesley Family Services in Pittsburgh, PA is seeking an Eligibility Specialist to join the Finance team. You will handle authorization of services, pre-billing activities, and employee credentialing for all payers, ensuring accuracy of client eligibility and authorization status.

The role requires attention to detail, administrative support experience in healthcare, and proficiency with Microsoft Office. You will regularly coordinate with payers, process authorizations, and maintain compliance