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Eligibility Specialist FT Days
4 months ago
The primary responsibility of this position is to facilitate the treatment authorization process for managed care patients (Medicare, HMO and PPO). In addition, this team member provides support to the front desk registration clerk personnel. Performs clerical duties as required by PIH Health Breast Center Whittier to meet the needs of the patient and facilitating the delivery of care.
PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook, Twitter, or Instagram.
Required Skills
- Excellent organizational, written and verbal communications and strong interpersonal skills
- Communicate effectively with staff, patients, guarantors, insurance companies, and physicians.
- Demonstrates attention to detail
- Good English speaking, spelling, reading and mathematical skills required
- Must possess excellent telephone etiquette, and customer service skills.
- Proficient computer skills and knowledge in Word, Excel, Outlook and ability to maneuver through multiple screens in a timely manner
- Ability to sort & file material correctly by alphabetic or numeric systems; computer data entry skills; ability to work effectively in fast-paced situations & tight deadlines
- Ability to stay on task in a fast and high pressured environment
- Strict adherence to all HIPAA laws
- Strong commitment to customer service with demonstrated ability to create a positive patient experience
- Demonstrates the ability to work well independently as well as part of a team
- Understanding of guidelines for commercial, senior, and Medi-Cal requirements to expedite the treatment authorization process
- Ability to develop effective working relationships with all levels of the organization, physician offices and health plans
Required Experience
Required:
- High School diploma or equivalent
- One-year experience performing hospital or medical group related insurance verification or receptionist experience in a hospital/medical office outpatient setting.
Preferred:
- Prior experience working in a breast imaging facility
- Medical terminology knowledge
- Medical insurance knowledge
- Bilingual skills (English/Spanish)
Qualifications:
- Excellent organizational, written and verbal communications and strong interpersonal skills
- Communicate effectively with staff, patients, guarantors, insurance companies, and physicians.
- Demonstrates attention to detail
- Good English speaking, spelling, reading and mathematical skills required
- Must possess excellent telephone etiquette, and customer service skills.
- Proficient computer skills and knowledge in Word, Excel, Outlook and ability to maneuver through multiple screens in a timely manner
- Ability to sort & file material correctly by alphabetic or numeric systems; computer data entry skills; ability to work effectively in fast-paced situations & tight deadlines
- Ability to stay on task in a fast and high pressured environment
- Strict adherence to all HIPAA laws
- Strong commitment to customer service with demonstrated ability to create a positive patient experience
- Demonstrates the ability to work well independently as well as part of a team
- Understanding of guidelines for commercial, senior, and Medi-Cal requirements to expedite the treatment authorization process
- Ability to develop effective working relationships with all levels of the organization, physician offices and health plans
