Practice made perfect

Join Our Talent Network

Eligibility Representative in Sunrise, FL at TeamHealth

Date Posted: 11/5/2018

Job Snapshot

Job Description

Join a team of dynamic, results oriented professionals!

Named among “The World’s Most Admired Companies" by Fortune Magazine
Named among "America's 100 Most Trustworthy Companies" by Forbes magazine
Named among “Great Places to Work" by Becker’s Hospital Review

  • Career Growth Opportunities
  • Convenience market on site
  • Benefit Eligibility (Medical/Dental/Vision/Life) the first of the month following 30 days of employment
  • 401K program (Discretionary matching funds available)
  • Employee Assistance Program
  • Referral Program
  • Dental plans & Vision plans
  • GENEROUS Personal time off
  • Eight Paid Holidays per year
  • Quarterly incentive plans
  • Business casual dress code
  • Free Parking
  • Free coffee daily
  • Employee of the month awards with monetary gift and parking space
  • Training Programs
  • Fitness Center with personal trainer on site
  • Awesome Facility with terrific amenities
  • Wellness programs
  • Flexible work schedule

JOB DESCRIPTION OVERVIEW:

The Eligibility Representative is responsible to process denials from the carriers by validating insurance information from various eligibility systems and update the patient’s demographic and insurance information.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Eligibility Representatives will process eligibility related denials, correct and refile to the appropriate carriers and report denials that are unrelated to eligibility to Management
  • Eligibility Representatives will check patient’s eligibility status through the GE system, HDX Express, Hospital systems, and carrier/website eligibility systems.
  • Eligibility Representatives refers to medical record face sheets if applicable for corrected insurance information and verifies eligibility to update and refile claims.
  • Eligibility Representatives enters and/or updates patient demographics and insurance information within the patients account.
  • Eligibility Representatives identifies patient’s insurance and assigns, in priority order, the appropriate Financial Status Classification (FSC)
  • Eligibility Representatives adheres to all department and company policies and procedures.

OTHER RESPONSIBILITIES:

  • Adheres to HIPPA/PHI guidelines. Consistently meets established timelines for projects and assignments.
  • Communicates with the Senior, Supervisor, and/or Manager on the progress of projects and assignments.
  • Works overtime as directed by management
  • Accepts other tasks, duties, and responsibilities as assigned.
  • Completes tasks accurately maintaining quality standards and productivity standards.

 

Job Requirements

POSITION REQUIREMENTS:

Skills

  • Thorough knowledge of billing and insurance procedures across multiple states.
  • Extensive knowledge of insurance carriers and product lines.
  • Knowledge of payer types for medical insurances.
  • Excellent oral and written communication skills.
  • Excellent organizational skills.
  • Ability to work efficiently in a high-volume, fast-paced environment while maintaining quality and production standards.
  • Proficiency with Microsoft Outlook, Microsoft Word. Eligibility Representatives must have basic knowledge of Excel spreadsheets and how to work from spreadsheets

Education

  • High School diploma or equivalent is required.

Experience

  • One year experience in medical insurance billing and eligibility verification.
  • Previous IDX-BAR applications experience a plus.

WORKING CONDITIONS:

  • Job performed in a well-lighted, modern office setting.
  • Prolonged work on a PC/computer.
  • Physical requirements include but are not limited to walking, lifting (20 lbs.) sitting, bending and standing for extended periods of time.

DISCLAIMER:

Cooperative, positive, courteous and professional behavior and conduct is an essential function of every position. All employees must be able to work with others beyond giving and receiving instructions. This includes getting along with co-workers, peers and management without exhibiting behavior extremes. Job functions may require personal leadership skills such as conflict resolution, negotiating, instructing, persuading, speaking with others as well as responding appropriately to job performance feedback from the supervisor. Additionally, the information contained in this job description has been designated to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this position.