Medical Eligibility Supervisor

5 days ago


San Antonio, Texas, United States CommuniCare Health Center Full time
Job Summary

We are seeking a highly skilled Medical Eligibility Supervisor to join our team at CommuniCare Health Center. As a key member of our staff, you will be responsible for overseeing the medical eligibility process for our patients, ensuring that they receive the necessary health insurance coverage.

Key Responsibilities
  • Supervise and train Medical Eligibility Specialists to ensure accurate and efficient processing of patient eligibility.
  • Oversee the enrollment process for QHP, Medicaid, and CHIP health insurance programs.
  • Conduct eligibility screenings and place clients on appropriate programs based on funding source requirements.
  • Maintain knowledge and expertise in eligibility, enrollment, and program specifications of the Federal Marketplace and other health coverage programs.
  • Ensure compliance with departmental policies and funding source requirements.
  • Provide exceptional customer service to patients, support staff, and third-party payors.
Requirements
  • High school diploma or equivalent.
  • Two years' experience in billing and collecting of third-party health insurance.
  • Significant expertise in billing and eligibility requirements for Medicare and Medicaid.
  • Two years' experience supervising and training staff in a healthcare setting.
  • Extensive knowledge of ICD-10-CM and CPT codes and medical terminology.
  • Advanced knowledge of computerized billing systems.
  • Proven proficiency in Excel spreadsheets, Microsoft Word, and Outlook.
Preferred Qualifications
  • EPM, EHR, CPC, RHIT, or equivalent certification.
  • Bilingual in English and Spanish.
Working Conditions

This position requires limited physical effort and may involve lifting folders, files, and other items weighing up to 25 pounds.



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