Insurance Verification & Patient 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

JFCS is seekinga detail-oriented professional tojoin our teamin a rolefocusedon supporting patientsand ensuring asmooth process foraccessing healthcareservices. This positioninvolves working closelywith patients, insuranceproviders, and internalteams to helpensure information isaccurate and servicesare appropriately coordinated.

• 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 electronic medical record (EMR) system.

Qualifications

• Previous experience as an Eligibility Specialist and demonstrated ability to manage multiple insurance plans including third-party insurance, AHCCCS, Medicaid and Medicare plans.
• Capacity to work with clinical staff, providers and follow payer guidelines and HIPAA regulations
• Ability to work in a fast-paced environment and provide excellent customer service and maintain documentation accuracy.
• Bilingual Strongly Preferred
• Must Receive/Maintain DPS Fingerprint Clearance
• High School Diploma or GED
• Must be able to perform the essential functions of the job including prolonged sitting and in certain positions driving, lifting 20lbs, walking, standing, and executing dexterity with a keyboard or smart pad.