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Billing and Eligibility Specialist

1 month ago

Nashville, Tennessee, United States Lucent Health Solutions, Inc. Full time
About Lucent Health Solutions, Inc.

We are a leading provider of healthcare benefits solutions, combining top-tier claims management with a compassionate, human-focused, data-driven care management approach. Our goal is to help self-insured employers provide care management that enables health plan participants to make informed, cost-saving healthcare decisions.

Job Summary

The Billing and Eligibility Specialist plays a critical role in the successful operation of our department, reporting to the Director of Technical Services. This position is responsible for ensuring the participant/client is serviced according to our business requirements, processing incoming eligibility/change/termination notices, and preparing and maintaining check runs.

Key Responsibilities
  • Ensure participant/client services meet our business requirements.
  • Process incoming eligibility/change/termination notices within 48 hours of receipt.
  • Notify Supervisor or Director of any turnaround time issues.
  • Notify participant/client of any missing data.
  • Prepare, maintain, and file check runs as directed.
  • Work with Group set up and Account Management to ensure accurate billing.
  • Create, review, and evaluate client bills for accuracy.
  • Inform Supervisor or Director of any disputes or communication from attorneys or government agencies.
  • Advise Eligibility Supervisor of any computer problems or error messages.
  • Work closely with the COBRA department to ensure Claims and COBRA systems are in sync.
  • Assist as needed with other departments.
  • Participate as a Team Member to ensure smooth department operation.
  • Comply with company policies and procedures.
Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Bachelor's degree (B.A.) from four-year college or university; or minimum of two years relevant experience or related experience and/or training; or equivalent combination of education and experience.