Healthcare Eligibility & Referral Data Clerk

Universal Health Services, Inc.; Riverside (CA); On-site; USD 42,000 - 56,000; Full time

Benefits offered by this job

Challenging work

Growth opportunities

Competitive compensation

Job summary

Riverside Medical Clinic, part of Universal Health Services, Inc., is seeking an eligibility and benefits specialist to verify patient benefits, process referrals, and handle data entry and authorizations to support timely patient care in the Riverside region.

This role involves coordinating with payors and provider offices, answering referral inquiries by phone, and maintaining accurate insurance records to ensure compliant, efficient service.

Qualifications

• High school diploma or GED required.

Responsibilities

• Review and submit authorization requests to respective health plan payor portals while maintaining internal deadlines.
• Answer phone calls regarding questions related to any referral inquiries.
• Monitor messages that are sent to, and received by, provider’s offices within a timely manner.
• Verify patient benefits and eligibility prior to requesting authorizing services or supplies.
• Update insurance records as necessary.
• Communicate system malfunctions and required benefit file updates, as necessary, to ensure system accuracy.
• Update authorizations on system to ensure timely turnaround and compliance with health plan requirements.

Education

High school diploma or GED

Job description

Riverside Medical Clinic, part of Universal Health Services, Inc., is seeking an eligibility and benefits specialist to verify patient benefits, process referrals, and handle data entry and authorizations to support timely patient care in the Riverside region.

This role involves coordinating with payors and provider offices, answering referral inquiries by phone, and maintaining accurate insurance records to ensure compliant, efficient service.