Job Description

• Maintain the appropriate level of work activity according to work standards and establish work processes to ensure timely certification for eligibility programs.
• Retrieve and forward requested records and information, including medical records, insurance policy information, remittance advice, and itemized statements, to appropriate parties.
• Analyze, distribute, and follow-up on special requests and adjustments with hospital personnel.
• Maintain consistent proactive communication with the patient or patient representative throughout the eligibility process, keeping the patient informed of the account progress.
• Screen patients and/or patient representatives to determine potential eligibility for Third Party resources.
• Communicate effectively with physicians, case managers, social workers, and hospital business office staff on a daily basis to ensure questions are answered and issues are addressed.
• Educate patients and patient representatives of the eligibility requirements, application process, and verification requirements for applicable programs.
• Maintain a professional relationship with the patient and governmental agencies to ensure cooperation and compliance.
• Document pertinent patient information and all work activity in the appropriate systems dictated by company policies and procedures.
• Ensure accounts are processed in accordance to Eligibility Program standards, Client expectations, and all applicable federal and state regulations guidelines.
• Responsible for understanding and complying with all policies, procedures, and regulations relating to job duties.
• Perform other duties as assigned by management.

• High School diploma or General Educational Development (GED) certificate or equivalent in relevant work experience desired.
• Previous healthcare coverage/eligibility experience preferred.
• Proficient personal computer skills including Microsoft Office.
• Ability to maintain the highest level of confidentiality.
• Bilingual (Spanish) a plus.
• Excellent interpersonal, written, and oral communication skills.
• Ability to work in a team fostered environment.
• Ability to work in a multi-tasked environment.
• Ability to prioritize and organize work.
• Ability to adapt to a flexible schedule.

• Office environment - Remote work is not available for this position.
• Ability to lift and/or move 20 pounds with or without accommodation.

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