Patient Eligibility Specialist - Remote

Patient Eligibility Specialist - Remote Position

Job Description:

Provides accurate and complete data for patient enrollment and offers excellent customer service.

Obtains prior authorizations for all insurance using payer-specific tools.

Reviews and analyzes clinical data for pre-authorization requests

Assists with the review process and necessary research of payers requesting additional information.

Communicate with clinical staff and partners to obtain additional information required for authorization approval.

Verify eligibility and benefits for each patient.

Responsible for entering detailed notes

Identifies opportunities for process improvement.

Maintains a working knowledge of all revenue cycle management computer systems 

Understands company processes, procedures, and policies and ensures adherence to company guidelines.

Performs other duties as assigned.

Required Experience

Minimum Experience: Some prior authorization experience.

Working knowledge of medical or insurance terminology preferred, but not required

Basic knowledge of medical clinic operating policies and procedures.

Knowledge of insurance agency reimbursement procedures and practices.

Knowledge and understanding of HIPAA guidelines 

Skilled in using computer programs and applications. 

Skilled in typing a minimum of 50 WPM.

Ability to read, understand, and follow oral and written instructions.

Ability to multi-task and communicate effectively.

Ability to analyze information and provide a solution.

Ability to handle pressure, heavy workload, and meet deadlines.

Ability to sort and file materials correctly by alphabetic or numeric systems.

High School diploma or equivalent. Associate degree preferred.