Insurance Eligibility & Patient Access Specialist

Jewish Family & Children's Service of Arizona; Mesa (AZ); On-site; USD 36,000 - 52,000; Full time

Job summary

Jewish Family & Children's Service of Arizona is seeking a detail-oriented Eligibility Specialist to support patients in accessing healthcare services. You will verify insurance eligibility, collect demographic information, and coordinate with AHCCCS, Medicaid, Medicare, and third-party plans to ensure coverage.

In this fast-paced role you will collaborate with clinical staff and insurance providers, process prior authorization requests, submit documentation, and maintain accurate EMR records.

Qualifications

• Experience as an Eligibility Specialist managing AHCCCS, Medicaid, Medicare and third-party plans.
• Ability to work with clinical staff and payers following guidelines and HIPAA regulations.
• Fast-paced environment, strong customer service and accurate documentation.
• Bilingual preferred.
• Fingerprinted DPS clearance required.
• High School Diploma or GED.
• Prolonged sitting, driving, lifting ~20lbs, walking, standing, and keyboard dexterity.

Responsibilities

• Obtains and updated copies of patients' insurance cards and demographic information.
• Determines and verifies patient insurance eligibility, benefits, and coverage for AHCCCS, Medicaid, Medicare and third-party insurance coverage.
• Engages with patients to determine if services requested need prior authorization.
• Submits authorization requests and tracks approvals to ensure timely patient care.
• Communicates with insurance companies to resolve authorization issues and claim denials.
• Maintains accurate patient insurance records in the EMR system.

Skills

Insurance eligibility

Customer service

HIPAA compliance

Documentation accuracy

Bilingual

Education

High School Diploma or GED

Job description

Jewish Family & Children's Service of Arizona is seeking a detail-oriented Eligibility Specialist to support patients in accessing healthcare services. You will verify insurance eligibility, collect demographic information, and coordinate with AHCCCS, Medicaid, Medicare, and third-party plans to ensure coverage.

In this fast-paced role you will collaborate with clinical staff and insurance providers, process prior authorization requests, submit documentation, and maintain accurate EMR records.