Patient Support Services - Eligibility Team (Full-Time)

Hudson Headwaters Health Network Inc.; West Glens Falls (NY); On-site; USD 22,000 - 32,000; Full time

Job summary

Hudson Headwaters Health Network Inc. is seeking a Patient Support Services Representative for the Eligibility Team. The role is full-time and in-person at The George Purdue Administrative Building with a 40-hour workweek, Monday–Friday 7am–3:30pm.

The incumbent will handle patient calls, insurance correspondence, and billing-related duties in a HIPAA-compliant environment. Required are a high school diploma or GED and at least three years of billing experience, with CPC preferred but not

Qualifications

• High school diploma or GED.
• At least three years billing experience or equivalent combination of education and experience.
• Certified Professional Coder preferred but not required.
• Strong customer service and organizational skills.
• Ability to interact professionally with managers, patients, insurance reps, and other departments.

Responsibilities

• Handle patient phone calls and insurance correspondence with HIPAA adherence.
• Verify accuracy of demographic and insurance information to support data quality.
• Communicate with Network staff and providers about eligibility, claims, and adjustments or appeals.
• Manage hold, MGRHOLD, and other buckets as assigned.
• Oversee correspondence dashboard, unpostable accounts, faxes, and mail.
• Understand refund processes by carrier to handle credit balances per Network policy.
• Collaborate with insurance companies and patients on claims resolution and deposits.
• Respond to internal and external correspondence regarding billing issues.
• Liaise with collections, coding, and billing vendors.
• Support Hudson Headwaters Health Network’s Mission, Vision, and Core Values.
• Perform additional duties and special projects as assigned.

Skills

Customer service

Organizational skills

Interacting with diverse groups

Education

HS diploma/ GED

Certified Professional Coder (CPC) preferred

Tools

Excel

Word

Athena

Job description

Patient Support Services - Eligibility Team (Full-Time)

#26-2222

Location

The George Purdue Administrative Building

Job Description

Proposed Schedule: 40 hours per week. Monday-Friday 7am-3:30pm.

The Patient Support Services Representative is responsible for patient phone calls, insurance correspondence, identifying billing trends and all other duties as assigned.

• Support all inquiries both internally and externally in a professional, courteous manner following HIPAA guidelines
• Support data quality by verifying accuracy of demographic and insurance information
• Support Network staff through verbal or written communication and education as needed, providing knowledge of participating insurances, eligibility status, claims inquiries, and adjustments or appeals.
• Oversee hold, MGRHOLD, and other buckets assigned
• Oversee correspondence dashboard, unpostable accounts, faxes, and mail
• Understand the refund process by carrier to facilitate credit balances in accordance with Network policy
• Works with insurance companies and patients on claims resolution, keeping current on changes with all companies. This includes but is not limited to calling insurances and working with provider relations representatives, collecting, and posting insurance payments, and completing deposits
• Answer all correspondence both internally and externally regarding billing issues
• Liaise with all collection, coding, and billing vendors
• Enthusiastically support the Mission, Vision, and Core Values of Hudson Headwaters Health Network
• Perform additional duties and special projects as assigned

Requirements

• High school diploma or general education degree (GED)
• At least three years billing experience or equivalent combination of education and experience
• Certified Professional Coder preferred but not required
• Strong customer service skills
• Strong organizational skills
• Ability to work with a variety of groups (managers, patients, insurance reps, other departments)
• Ability to interact in a professional and efficient manner
• Excellent computer skills, proficient in Excel and Word, Athena a plus

The pay rate for this position is $19.77/hour.

Work Location

In-Person

EEO is the Law