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Registration Eligibility Specialist II in Los Angeles, CA at TeamHealth

Date Posted: 12/17/2018

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:

Under direct supervision, the Registration Eligibility Specialist II is responsible for working from various payer reports or projects. The Registration Eligibility Specialist II carries out his/her duties by adhering to the highest standards of ethical and moral conduct, and acts in the best interest of TeamHealth.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Responsible for having working knowledge of payer eligibility and benefits verification/billing guidelines.
  • Responsible for printing facesheets through hospital facility’s electronic access
  • Responsible for retrieving patient facesheets either electronically or via fax
  • Has complete understanding and working knowledge of navigating payer websites.
  • Researches insurance eligibility via website or by calling the insurance company, patient, or hospital in order to resolve eligibility denials/rejections in a timely and accurate manner.
  • Maintains thorough and detailed knowledge of various insurance contracts and eligibility denials and follow up guidelines.
  • Enters corrections and reposts to the correct insurance type.
  • Maintains good working knowledge of the contract tables and Case Rate plans.
  • Responsible for performing required transactions on facility denial projects.
  • Receives facility denials projects and works them quickly and accurately.
  • Tracks all outstanding projects and reports status to superior.
  • Identifies improvement opportunities, monitors trends with facility that may result in issues.
  • Coordinates with and provides feedback to the Manager and Analyst regarding errors or issues that affects the department workflow.
  • Ensures compliance with state and federal laws and regulations for Commercial, Medicare, Medicaid, Managed Care and self-pay payers.
  • Maintains ongoing knowledge of HCFA 1500 and other mandatory state billing forms and filling and follow up requirements and ensures compliance of CPT, HCPCS and ICD-9/ICD-10 coding regulations and guidelines.
  • Maintains ongoing knowledge of policies, procedures and other mandatory requirements and ensures compliance.
  • Maintains and exceeds department standards for productivity and quality.
  • Continually seeks to understand and act upon customer needs, concerns, and priorities.
  • Meets customer expectations and requirements, and gains customer trust and respect.
  • Consistently communicates with the Analyst and other team members on the most current and up to date information related to a specific payer(s) and will work closely with them to enhance cooperativeness and increase efficiencies.
  • Functions effectively within a team and participates and contributes constructively to produce results in a cooperative effort.
  • Demonstrates ongoing enthusiasm and commitment to the work assigned.
  • May perform special assignments and other related tasks as assigned.

 

 

Job Requirements

QUALIFICATIONS / EXPERIENCE:

  • Normally, the knowledge, skills and abilities necessary for adequate job performance can be obtained through approximately 2+ years’ billing experience within a multi-facility environment (particularly facility denials and eligibility verification).
  • Billing experience or graduation of vocational medical billing college helpful.
  • Also, demonstrated success working in a team environment focused on meeting organization goals and objectives is necessary.
  • Experience with providing visible participation and support of major change initiatives preferred.
  • Knowledge of basic math and the ability to perform math functions in units of American currency.
  • Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram form.
  • Ability to review documents for accuracy and reasonability.
  • Ability to determine priorities.
  • Ability to coordinate schedules and information.
  • Ability to work well under pressure.
  • Tact and patience when dealing with individuals at all levels, both within and outside the company.
  • Commitment to TeamHealth values
  • Ability to communicate effectively orally, in person and on the telephone, and in writing, with individuals at all levels, both within and outside the company.
  • Knowledge of coordination of benefits requirements and processes.
  • Ability to multi-task, set priorities and follow through without direct supervision.
  • Ability to type efficiently and accurately (minimum of 45 words per minute) including 10-key.
  • Ability to operate a computer (i.e., Microsoft Office) efficiently and accurately.
  • Ability to use the Internet.
  • Ability to operate various office machines (i.e., fax, copier).
  • Ability to work well in a team environment and be flexible in problem solving environment.

PHYSICAL / ENVIRONMENTAL DEMANDS:

  • Have good attendance.
  • Work at a desk, utilizing a computer.
  • Communicate by telephone.
  • Operate a PC and other office equipment (copier, fax, etc.).
  • Move freely between offices
  • The work environment corresponds to the average office environment.

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.