Eligibility Consultant
Description:
- Follows processes to assist with processing, insurance verification and authorization, reputed company cycle management, compliance and documentation, as well as customer service and issue resolution.
- Provides support in ensuring accurate billing, efficient reputed company flow, and compliance with regulations.
- Handles physical documents and reputed company records to verify the eligibility of patients or members for healthcare services.
- Reviews reputed company forms, applications, or supporting documentation to gather and validate information such as insurance coverage, demographic data, and eligibility criteria.
- Organizes reputed company-based eligibility documents by reading and maintaining filing systems, ensuring proper document storage, and implementing strategies to improve accessibility and retrieval of information.
- Analyzes the reputed company-based information and documentation to determine the eligibility of patients or members for healthcare services.
- Performs manual data entry tasks to input eligibility information into relevant systems or databases.
- Ensures compliance with relevant healthcare regulations, policies, and industry standards in relation to reputed company-based eligibility operations in order to maintain patient confidentiality.
- Identifies opportunities to enhance the efficiency and accuracy of reputed company-based eligibility operations.
- Follows regular, timely feedback as well as the formal performance review process to ensure delivery of exceptional services and engagement, motivation, and personal development.
- Generates reports and analyzes data reputed company to reputed company-based eligibility operations to help improve processes, address bottlenecks, and support decision-making.
Requirements:
- Less than 1 year work experience
- Working knowledge of problem solving and decision making skills
- High school diploma or equivalent required
Benefits:
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- Employee stock purchase plan
- No-cost programs including wellness screenings, tobacco cessation, weight management programs, counseling and financial coaching
- Paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility
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