Eligibility Specialist - Houston, United States - St. Hope Foundation

Description

Job Description

We are seeking an Eligibility Specialist to become a part of our team You will be responsible for processing insurance claims for healthcare facilities.

Responsibilities:

• Consistently follow up on unpaid claims utilizing monthly aging reports
• Filing appeals when appropriate to obtain maximum reimbursement.
• Establish and maintain strong relationships with providers, clients, patients, and staff.
• Data entry of all patient demographic, guarantor, and insurance information, posting procedures and insurance/patient payments, balance to daily deposits.
• Accurately Post all insurance payments by line item.
• Timely follow up on insurance claim denials, exceptions, or exclusions.
• Reading and interpreting insurance explanation of benefits.
• Provide additional information as requested by insurance companies.
• Demonstrate flexibility, enthusiasm, and willingness to cooperate while working with others in inter-professional care teams with activities to include participating in daily huddles.

Qualifications:

• High School diploma or equivalent.
• Medical Billing and Coding certificate or at least two years of medical billing and coding experience.
• Experience in CPT and ICD-10 coding; familiarity with medical terminology.
• Good keyboard skills - 35 wpm
• Ability to work with frequent interruptions and maintain emotional control under stress.
• Detailed oriented and organized.
• Great customer service and communication skills

Working Conditions:

• The position occasionally requires sitting, standing and bending. Occasional very light lifting, up to 20 pounds or an equivalent weight may be required.

Employment Benefits:

• Paid Time Off Plan, Comprehensive Medical/Dental/Vision, Life Insurance, 401k (6% Match), Paid Federal Holidays, Tuition Reimbursement, New Homeownership Incentive, New Certification/Licensure Bonus, Loan Forgiveness (Conditions apply).

EEO Statement: St. Hope Foundation is an equal opportunity employer and will not discriminate against any employee or applicant on the basis of age, color, disability, gender, national origin, race, religion, sexual orientation, veteran status, or any classification protected by federal, state, or local law.