Insurance Eligibility Specialist

4 weeks ago


Rio Rancho, United States University of New Mexico Full time

Position Summary:

The Insurance Eligibility Specialist will verify insurance coverage, obtain necessary authorizations, and ensure adherence to Hospitals and departmental policies and procedures. Additionally, they will provide financial assistance and navigate patients through their financial options including UNMH or other UNM Health Systems financial assistance, NM Medicaid, or other State and Federal Programs.

Detailed responsibilities:

  • Verify insurance coverage, obtain necessary authorizations, and document correctly into the hospital system
  • Provide navigation and financial assistance to patients for UNMH financial programs, NM Medicaid, or other State and Federal Programs
  • Determine patient eligibility for financial assistance including Medicare, self-pay, or other commercial insurances
  • Assist patients in finding appropriate financial resources in the community (EMSA)
  • Assure proper adherence to hospital policies and procedures

Qualifications:

  • High School or GED equivalent
  • 2 years directly related experience
  • Bilingual English/Keres, Tewa, Tiwa, Towa, Zuni, or Navajo (nonessential)

Working Conditions:

  • No or minimal hazard or physical risk in an office environment
  • May be required to travel to various work sites
  • May be required or is required to rotate work shifts

Department: Behavioral and Mental Health



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