Healthcare Eligibility & Benefits Counselor

Chase-Brexton-Health-Care; Baltimore (MD); On-site; USD 42,000 - 62,000; Full time

Job summary

Chase Brexton Health Care is seeking a Financial Eligibility Specialist to determine eligibility for third-party reimbursement and to process data for admission of new patients. You will also handle inquiries and ensure correct coding for insurance billing.

Responsibilities include calculating fee scales, linking patients to insurance or assistance programs, and maintaining eligibility records with accuracy. A CAC designation within three months and strong office skills are required.

Qualifications

• High School Diploma or GED required; CAC designation due within 3 months.
• At least 3 years of experience with insurance verification and sliding fee scales.
• Familiarity with Medicaid, Medicare, MADAP and third-party insurance screening.
• Knowledge of ICD-10-CM/ CPT coding helpful; billing practices experience preferred.
• Ability to communicate with diverse patients and coordinate referrals.

Responsibilities

• Determines fee scale and insurance eligibility per program procedures.
• Calculates and applies the Ryan White Cap correctly.
• Links patients to eligible insurance and/or assistance programs.
• Ensures eligibility information is documented and reported timely.
• Refer clients to medical case managers for additional assistance.
• Register clients in CPS and complete case management notes.
• Complete required paperwork and maintain orderly files.
• Provide monthly reporting of patient statistics and metrics.
• Respond to Sliding Fee-related billing inquiries as needed.
• Conduct renewal eligibility as required by programs.
• Participate in workgroups and special projects.

Skills

Bookkeeping terminology

Computer literacy

Cultural competence

Under pressure

Education

High School Diploma or GED

Certified Application Counselor designation within 3 months

3+ years insurance verification / sliding fee experience

ICD-A / CPT codes knowledge

Insurance and billing practices knowledge

Job description

Chase Brexton Health Care is seeking a Financial Eligibility Specialist to determine eligibility for third-party reimbursement and to process data for admission of new patients. You will also handle inquiries and ensure correct coding for insurance billing.

Responsibilities include calculating fee scales, linking patients to insurance or assistance programs, and maintaining eligibility records with accuracy. A CAC designation within three months and strong office skills are required.