Eligibility Specialist

2 weeks ago

San Bernardino, California, United States GetixHealth Full time
{"title": "Eligibility Screener", "description": "Job Summary

We are seeking a highly skilled Eligibility Screener to join our team at GetixHealth. As an Eligibility Screener, you will play a critical role in assisting patients with applications for third-party resources, including state aide. This is an onsite position only, and you will be working in a local hospital environment.

Key Responsibilities
  • Screen patients and/or patient representatives to determine eligibility for Third Party resources.
  • Educate patients and patient representatives on the eligibility requirements, application process, and verification requirements for applicable programs.
  • Maintain a professional relationship with patients and governmental agencies to ensure cooperation and compliance.
  • Document pertinent patient information and all work activity in the appropriate systems dictated by company policies and procedures.
  • Ensure accounts are processed in accordance with Eligibility Program standards, client expectations, and all applicable federal and state regulations guidelines.
  • Maintain the appropriate level of work activity according to work standards and establish work processes to ensure timely certification for eligibility programs.
  • Retrieve and forward requested records and information, including medical records, insurance policy information, remittance advice, and itemized statements, to appropriate parties.
  • Analyze, distribute, and follow-up on special requests and adjustments with hospital personnel.
  • Maintain consistent proactive communication with patients or patient representatives throughout the eligibility process, keeping them informed of account progress.
  • Communicate effectively with physicians, case managers, social workers, and hospital business office staff on a daily basis to ensure questions are answered and issues are addressed.
  • Educate patients and patient representatives on the eligibility requirements, application process, and verification requirements for applicable programs.
  • Responsible for understanding and complying with all policies, procedures, and regulations relating to job duties.
  • Perform other duties as assigned by management.
Requirements
  • High School diploma or General Educational Development (GED) certificate or equivalent in relevant work experience desired.
  • Previous healthcare coverage/eligibility experience preferred.
  • Proficient personal computer skills including Microsoft Office.
  • Ability to maintain the highest level of confidentiality.
  • Bilingual (Spanish) a plus.
  • Excellent interpersonal, written, and oral communication skills.
  • Willing and able to work inside of a hospital, including visiting hospital rooms to complete tasks, which requires a vaccination regimen and drug screening.
  • Ability to work in a team-fostered environment.
  • Ability to work in a multi-tasked environment.
  • Ability to prioritize and organize work.
  • Ability to adapt to a flexible schedule.
Work Environment
  • Office environment and patient rooms, within a local hospital.
  • Ability to lift and/or move 20 pounds with or without accommodation.
  • Heavy walking is required.
Benefits and Incentives
  • Comprehensive Health Coverage:
    • Group medical, dental, and vision plans available from the first day of the month following 90 days of full-time employment.
  • Life and Disability Insurance:
    • Basic life/AD&D, short-term, and long-term disability coverage provided, with options for voluntary life/AD&D.
  • 401(k) Retirement Savings Plan:
    • Eligible to participate in the company's 401(k) plan at the beginning of the first calendar quarter following 6 months of continuous service.
  • Paid Time Off (PTO):
    • Accrue Paid Time Off starting on your first day of employment.
  • Flexibility in Benefits:
    • The company reserves the right to amend, modify, or terminate any benefits programs as needed.
"}

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