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Eligibility Specialist

1 month ago

Houston, Texas, United States Houston Journal of Health Law & Policy Full time
Job Summary

As an Eligibility Specialist at Houston Journal of Health Law & Policy, you will play a critical role in determining applicant eligibility for third-party reimbursement. Your responsibilities will include processing data necessary for admission of new patients into health services, ensuring proper coding for insurance billing, and handling inquiries from prospective applicants and patients.

Key Responsibilities
  1. Conduct eligibility assessments for clients following established processes and guidelines.
  2. Participate in client recruitment and education in the community regarding services, programs, and eligibility.
  3. Verify that clients do not have another payer source, such as Medicaid, Medicare, ADAP, or any other third-party insurance.
  4. Register clients into applicable systems.
  5. Complete all necessary paperwork and perform data entry of eligible clients into electronic systems.
  6. Maintain up-to-date and orderly eligibility files and conduct renewal eligibility as required by each program.
  7. Confirm eligibility appointments with clients and schedule appointments with potential clients.
  8. Set initial service appointments once eligibility has been determined.
  9. Provide clients with lists of required eligibility documentation.

Requirements

This role requires an Associate's degree and a minimum of three years of directly related experience. The ideal candidate will have advanced vocational or electronic skills, as well as a basic knowledge of a professional field. The ability to analyze and interpret procedures, policies, and practices is essential for success in this position.