Eligibility Specialist

At SCP Health, what you do matters
As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care.
Why you will love working here:
- Strong track record of providing excellent work/life balance.
- Comprehensive benefits package and competitive compensation.
- Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect.
The Eligibility Specialist is responsible for accurately resolving registration and eligibility edits, related to the demographic and/or insurance information, based on departmental policies and procedures and feedback received from various payors. This person assists chart flow through the PreBilling processes and maintain inventory levels to ensure timely, effective and accurate chart processing while maximizing revenue.
Responsibilities:
Update demographics and/or insurance information based on feedback provided by internal or payor edits, using available resources: face sheets, insurance cards, eligibility results etc.
Determine the appropriate insurance carrier and billing information from the data contained in the patient’s medical record and use that information to accurately update a patient’s account in the billing system
When insufficient or questionable data is supplied in the medical record, contact the appropriate insurance carrier or facility to acquire accurate data
Utilize the Eligibility process/data in Centricity or on the payors’ websites to obtain more accurate information on each patient returned with an edit
Request additional insurance company entries in Centricity when necessary
Request direction and clarification from supervisor or lead when necessary, in order to assure accurate resolution of edits
Identify and work complex edits presented from various sources
Identify and report results of user and/or system issues that impact billing quality
Maintain understanding of current departmental policies and procedures
Promote a team environment that will support the growth of every department member and achievement of all department goals as a result of team work
Actively participate in meetings and educational programs in an effort to improve both individual and team quality and effectiveness
Knowledge, Skills and Abilities:
Detail oriented and organized
Self-motivated; capable of compiling/tracking data to meet deadlines and goals
Excellent interpersonal skills
Ability to work equally well individually and in a team environment
Professional attitude and demeanor
Written and oral communication skills
Proficient computer knowledge of Word, Excel, Windows and Outlook
Quick learner with an aptitude for custom computer systems
Previous success and comfort with entering data for extended time periods and limited interruptions
Pay Range:
15.00 - 21.00 USD per hour
This range represents the anticipated base salary for this role. Actual compensation will be determined based on experience, qualifications, and internal equity considerations.
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We offer a comprehensive benefits package designed to support your health, financial well-being, and work-life balance, including medical dental, vision insurance, a 401(k) plan with a company match, paid time off and holidays, professional development support, and employee wellness resources.
Visit our website for further information. https://myscpbenefits.com/
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Skills
Excel