Eligibility Verification Specialist

hace 1 semana


San Pedro Garza García, Nuevo León, México Pediatric Associates A tiempo completo

Job Summary: We are seeking a highly detail-oriented Eligibility Verification Specialist to join our team at Pediatric Associates. As a key member of our medical home, you will play a crucial role in verifying insurance eligibility for future patient appointments, documenting eligibility notes, and performing patient outreach as needed.

Key Responsibilities:

  • Verify insurance eligibility for future patient appointments using Pediatric Associates Eligibility Verification Quality Checklist
  • Review patient insurance for future appointments and identify eligibility requirements based on health plan
  • Use all available resources to determine insurance eligibility, including system, web portals, and phone
  • Update patient insurance details accurately and document action taken
  • Identify eligibility issues, communicate them to patients/parents, and document action taken
  • Complete all assigned appointments efficiently and within the expected timeframe
  • Communicate with office location via email, Microsoft Teams, and/or phone to coordinate patient callbacks for appointment rescheduling
  • Communicate effectively with supervisor, escalating issues as needed
  • Meet productivity standards as determined

Requirements:

  • High School Diploma or equivalent
  • Proficient in English and Spanish
  • 1-2 years of experience preferred
  • Detail-oriented and able to efficiently complete a high-volume of tasks using many sources
  • Excellent documentation skills required

Working Conditions:

Working in a professional office environment, clear and concise communication using email and phone is necessary. Requires manual dexterity sufficient to operate a keyboard, type at 35 wpm, operate copier, and other office equipment as necessary.

Pediatric Associates is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.



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