Eligibility Consultant - Paper Operations
Description:
- Follows processes to assist with processing, insurance verification and authorization, revenue cycle management, compliance and documentation, as well as customer service and issue resolution.
- Provides support in ensuring accurate billing, efficient revenue flow, and compliance with regulations.
- Handles physical documents and paper records to verify the eligibility of patients or members for healthcare services.
- Reviews paper forms, applications, or supporting documentation to gather and validate information such as insurance coverage, demographic data, and eligibility criteria.
- Organizes paper-based eligibility documents by reading and maintaining filing systems, ensuring proper document storage, and implementing strategies to improve accessibility and retrieval of information.
- Analyzes the paper-based information and documentation to determine the eligibility of patients or members for healthcare services.
- Performs manual data entry tasks to input eligibility information into relevant systems or databases.
- Ensures compliance with relevant healthcare regulations, policies, and industry standards in relation to paper-based eligibility operations in order to maintain patient confidentiality.
- Identifies opportunities to enhance the efficiency and accuracy of paper-based eligibility operations.
- Follows regular, timely feedback as well as the formal performance review process to ensure delivery of exceptional services and engagement, motivation, and personal development.
- Generates reports and analyzes data related to paper-based eligibility operations to help improve processes, address bottlenecks, and support decision-making.
Requirements:
- Less than 1 year work experience
- Working knowledge of problem solving and decision making skills
- Education High school diploma or equivalent required.
Benefits:
- Affordable medical plan options
- a 401(k) plan (including matching company contributions)
- an employee stock purchase plan
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
- Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.