Eligibility specialist Jobs in Nashville, TN

Job Description

Job Description

Essential Functions :

• Verify all new, returning, and annual patient eligibility including private, government and third party insurance information within assigned territory or clinics.
• Verify primary, secondary & tertiary medical benefits and patient responsibility such as deductible, out of pocket, copay and coinsurance.
• Verify if any prior authorizations are required pre-treatment such as HMO or PCP authorizations initiating authorization request and confirming with the office staff once received
• Verify and obtain authorization if required for services ordered
• Utilize online insurance portals and eligibility tools in order to obtain accurate verifications
• Provide accurate and timely estimated patient responsibility amounts to patient service staff members.
• Coordinate with Financial Counselor, Patient Navigator and front office staff to ensure smooth collection process.
• Maintains appropriate documentation in clinic systems and EMR.
• Communicate with patients as needed in order to obtain updated insurance information
• Update patient account with all necessary insurance information
• Contribute to the design of a centralized VOB model working closely with the ION Revenue Cycle Managers
• Maintain excellent customer service and kindness with all patients and staff
• Regular attendance and punctuality.
• Execute all functions of the role with positivity and team effort by accomplishing related results as needed.
• Ensures that all processing and reporting deadlines are consistently achieved.
• Perform any other functions as required by management

Qualifications and Education Requirements

Preferred Skills