Eligibility Specialist
Description
At SCP Health, what you do matters
As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care.
As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care.
Why you will love working here:
- Strong track record of providing excellent work/life balance.
- Comprehensive benefits package and competitive compensation
- Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect.
What you’ll be doing:
Responsible for accurately resolving registration and eligibility edits, related to the demographic and/or insurance information, based on departmental policies and procedures and feedback received from various payors. Assist chart flow through the PreBilling processes and maintain inventory levels to ensure timely, effective, and accurate chart processing while maximizing revenue.
- When insufficient or questionable data is supplied in the medical record, contact the appropriate insurance carrier or facility to acquire accurate data.
- Utilize the Eligibility process/data in Athena or on the payors’ websites to obtain more accurate information on each patient returned with an edit.
- Request additional insurance company entries in Athena when necessary.
- Request direction and clarification from supervisor or lead, when necessary, in order to assure accurate resolution of edits.
- Identify and work complex edits presented from various sources.
- Identify and report results of user and/or system issues that impact billing quality.
- Maintain understanding of current departmental policies and procedures
- Promote a team environment that will support the growth of every department member and achievement of all department goals because of teamwork.
- Actively participate in meetings and educational programs to improve both individual and team quality and effectiveness.
Who/What we are looking for:
- High school diploma or equivalent
- One year experience in a medical (billing preferably) environment
- One year experience in a fast-paced production environment
- One year experience (preferred) verifying eligibility with various insurance carriers.
- Detail oriented and organized.
- Self-motivated; capable of compiling/tracking data to meet deadlines and goals.
- Excellent interpersonal skills
- Ability to work equally well individually and in a team environment and adhere to our CORE values of Agility, Courage, Collaboration and Respect
- Professional attitude and demeanor
- Written and oral communication skills
- Proficient computer knowledge of Word, Excel, Windows, and Outlook
- Quick learner with an aptitude for custom computer systems
- Previous success and comfort with entering data for extended time periods and limited interruptions.
SCP Health and its affiliated companies (collectively, “SCP Health”) require applicants for specific positions, such as those onsite at a client company/healthcare facility or affiliate to be vaccinated against COVID-19 as a condition of employment, except where prohibited by state or local law. To demonstrate compliance with SCP Health’s vaccination policy, proof of COVID-19 vaccination status will be requested upon a conditional offer of employment for onsite positions at a client company/healthcare facility. SCP health will consider religious and/or medical/disability accommodation and other legally required exemption request as required by applicable law.
Join our social circle:
SCP Health is an Equal Opportunity Employer.
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