Client Eligibility Advisor

4 weeks ago

Cincinnati, Ohio, United States NECCO (ED Necco & Associates Inc.) Full time

Necco is offering a rewarding opportunity for a position as an Eligibility Specialist. This role is essential in enhancing the operational efficiency of our team while serving as a crucial link to the finance department.


Ideal Candidate Profile:
The successful candidate will be a proactive leader who excels in strategic decision-making. A strong communicator, they will focus on achieving impactful outcomes. They will be a resilient problem-solver, adept at financial management, and skilled in fostering collaboration. A dedicated advocate for the organization’s success, growth, and program excellence.

Key Responsibilities:
  • Assess eligibility, behavioral health coverage, copay, and deductible details with commercial insurance providers prior to client meetings.
  • Engage with clients and guardians to update coverage information when existing data cannot be confirmed.
  • Inform clients and guardians about full payment obligations and self-pay options.
  • Manage weekly schedules and conduct daily reviews for updates.
  • Confirm Medicaid eligibility and benefits before appointments using eligibility systems.
  • Verify eligibility for Aetna Ohio Rise clients prior to each session; for non-Aetna Ohio Rise clients, verification will occur monthly.
  • Remind clients and guardians about appointments and necessary documentation or copays.
  • Document all client copays and deductibles in the Electronic Health Record (EHR) for each visit.
  • Secure and record prior authorizations for all services in the EHR.
  • Generate necessary reports and take action if further prior authorizations are required.
  • Collaborate with treatment teams regarding services needing additional prior authorizations.

Team Collaboration:
  • Deliver exceptional customer service to all stakeholders.
  • Facilitate the flow of external communications within the team (e.g., phone, fax, mail, and email).
  • Assist in training and orienting new employees on eligibility verification, benefits, and procedural protocols.
  • Participate in Necco meetings, team conference calls, and organizational activities.
  • Communicate in a responsible, courteous, and professional manner with clients, guardians, and team members.
  • Maintain the confidentiality of client records and the office environment.
  • Accept additional responsibilities from the self-directed work team as needed.
  • Understand and implement our corporate culture principles and strategic objectives.
  • Contribute to our mission of Real People Helping Real Kids.
  • Engage with and take ownership of the Individual Performance Scorecard.
  • Practice Ruthless Pragmatism.
  • Embody the core values of Humble, Hungry, and Smart.
  • Drive your Individual Performance Scorecard.
  • Adhere to and contribute to the Necco meeting structure.

Position Requirements:
  • Must be at least 21 years of age.
  • High school diploma required (degree preferred).
  • Valid driver's license.
  • A minimum of 3 years' experience in office administration, data entry, and/or billing.
  • Willingness to undergo training and travel as necessary.
  • Exceptional organizational and technological skills.
  • Strong written and verbal communication abilities.
  • Successful completion of all mandated criminal background checks.
  • Proficient in using software applications (e.g., Microsoft Office, Database, Electronic Health Record, Dashboard).
  • Ability to identify issues and engage with relevant team members.
  • Capability to enter data accurately and in a timely manner.
  • Ability to meet scheduled and unplanned deadlines.

At Necco, we are committed to fostering a diverse and inclusive workplace. We welcome individuals from various backgrounds, experiences, and perspectives, believing that diversity drives innovation and creativity. We are dedicated to providing equal employment opportunities to all qualified candidates and encourage applicants from all backgrounds to consider joining our team.

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