Insurance Eligibility Coordinator

General Summary of Duties

This position is responsible for the coordination of various insurance requirements and is expected to be proactively and retroactively reviewing patient accounts. This individual will be involved in on-going communication and coordinate information to various stakeholders in a timely manner. The Insurance Eligibility Coordinator will work with various patients, insurers, providers, and staff to stay compliant with federal and state insurance guidelines.

Practice Manager

Position eligible to be utilized with practice volume as measurement of 75 or more patients a day

• Perform pre-registration and insurance verification on all patients
• Contact appropriate parties to resolve issues regarding prior authorizations and necessary referral requirements
• Assign insurance plans accurately
• Communicate with appropriate parties to discuss any insurance criteria
• Verify and utilize online carrier portals and websites to calculate patient cost share and assist patient with payment to appropriate departments
• Coordinate and oversee all Good Faith Estimates and the federally mandated requirements
• Resolve and oversee denied billing issues for various insurance companies
• Assist in answering incoming calls and ensure patient questions are answered and screened appropriately
• Collect co-pays and discusses reasoning for past due balances with patients
• Performs other related job functions as assigned
• Ability to work with co-workers, patients, various stakeholders, and management in a positive supportive, and cooperative manner
• Participates in educational activities and attends monthly staff meetings
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations
• Performs other related job functions as assigned

• Associate Degree preferred

• A minimum of two years of medical office or acute care setting healthcare experience required
• A minimum of one year of health insurance related experience required

• None