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Insurance Eligibility Coordinator

2 months ago

Baltimore, Maryland, United States Chase Brexton Health Care Full time

Healthcare Eligibility Analyst

We are looking for a dedicated Healthcare Eligibility Analyst to become part of our organization. This position focuses on assessing applicant qualifications for third-party reimbursement, managing data for new patient admissions, ensuring accurate coding for insurance claims, and addressing inquiries from potential applicants and patients. This role does not involve discussions regarding billing matters unrelated to Sliding Fee charges.

Key Responsibilities:

  • Evaluate fee scales and insurance eligibility for clients
  • Calculate and apply the Ryan White Cap
  • Analyze relevant reports and connect patients to insurance and/or assistance programs
  • Ensure correct fee scale application for other payment sources
  • Refer clients to medical case managers for further support
  • Adhere to Maryland insurance regulations and organizational policies
  • Maintain eligibility documentation and generate comprehensive reports
  • Coordinate renewal eligibility and engage in special initiatives
  • Confirm eligibility appointments and schedule service appointments for patients
  • Provide necessary eligibility documentation to clients
  • Direct patients to new services based on their treatment requirements

Required Skills and Qualifications:

  • Certification as an Application Counselor is mandatory
  • Familiarity with bookkeeping and accounting terminology
  • Proficient in operating computers and office equipment
  • Cultural competence and the ability to deliver personalized care
  • Bilingual candidates are preferred
  • Ability to manage responsibilities and perform under pressure

Education and Experience Requirements:

  • High School Diploma or GED is required
  • Certification as an Application Counselor must be obtained within three (3) months of employment
  • A minimum of three (3) years of experience in insurance verification is required
  • Experience with ICD-A / CPT coding is preferred
  • Understanding of insurance and billing practices is advantageous

Work Environment:

This role is primarily conducted in an office setting.

This description highlights the essential duties of the Healthcare Eligibility Analyst position. Join us in contributing to the community through our healthcare services.