BENEFITS ELIGIBILITY SPECIALIST - HOME CARE

Benefits Eligibility Specialist - Home Care

Job Category : Operations Requisition Number : BENEF003540 Showing 1 location Job Details

Description

Job Title / Position : Eligibility Specialist

Reports To : Billing Manager

JOB DESCRIPTION SUMMARY :

The Eligibility Specialist is responsible for processing and verification of eligibility accounts and will be the customer liaison between Pinnacle Home Care and the Payer / Patients for all transactions on assigned accounts.

Essential Duties and Responsibilities :

1 Verification of patient insurance eligibility upon intake for new and returning patients.

2 Reviews and resolves KanTime eligibility issues.

3 Processes insurance changes when necessary.

4 Capture eligibility and benefit details on patient chart including co-pay amounts, limitations of plan and deductibles.

5 Communicate with branch when patient eligibility has changed.

6 Meet productivity goals as assigned by the Billing / Reimbursement Manager.

7 Communicates professionally with inter-company departments on resolution of potential disputed items.

8 Responds to all inquiries with a resolution to concerns and or discrepancies.

9 Complies with HIPAA regulations on all accounts

10 Follows Pinnacle Home Cares Attendance Policy.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents in this job.

The incumbents may be requested to perform job related tasks other than those stated in this description.*

POSITION QUALIFICATIONS :

• 1 Must have knowledge in using Word Processing Software, Spreadsheet Software, and Electronic Medical Records Software
• 2 Must be able to work independently through high levels of workload under minimal supervision.
• 3 Ability to Identify needs and opportunities and present them to the supervisor with recommended solutions.
• 4 Strong organizational and communication skills required.
• 5 Minimum education for this position is a GED
• Minimum of one (1) year healthcare and customer service is required. Clinical Home health experience preferred.

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