Eligibility Specialist

Graystone Eye is looking for an individual who is willing to serve our patients with one vision in mind:

Achieving Exemplary
Exemplary Clinical Outcomes
&
Providing an
Unparalleled Experience for Patients,
Employees, and Families

Are you passionate about helping others?Are you looking for an organization in which you have a team helping you with your growth and development?

Join Graystone Eye, where our vision is to Achieve Exemplary Clinical Outcomes and Provide an Unparalleled Experience for Patients, Employees and Families.

We are looking for an Eligibility Specialist for whom primary responsibilities will be to ensure that patient's insurance eligibility is verified prior to scheduled appointments and contacts cancellations and no/shows to reschedule on a daily basis.

We offer a competitive salary and benefits.

The Job Requirements and Duties are the following:

• Communicates to appropriate personnel of any delays, changes, or cancellations regarding patient status
• Communicates to patient their insurance status and updates information in the system, when applicable
• Collects patient's demographics and insurance information
• Knowledge and understanding of co-insurance, co-payments, deductible, and out-of-pocket costs.
• Verify patient insurance eligibility/benefits, acquire pre-determination/prior authorization, confirm facility compatibility.
• Document patient benefits and calculate patient out of pocket amounts
• Maintain and update insurance policy information in NextGen and Phreesia system
• Verify eligibility run report 5-7 days in advance and update any not completed
• Search for, set-up, and maintain third party website access to perform eligibility and verification functions
• Verifies daily reports (appointment listings/booking out, no shows, waitlist, physician schedules, etc.) and utilizes to fill schedules
• Place calls to patients who have not confirmed upcoming appointments, have missed previous appointments, and utilize reports to fill open appointment slots
• Assists patients with rescheduling when necessary
• Scans and files documentation into patient's chart
• Assists patients with any concerns, directing them in the area needed, via phone
• Any duties deemed necessary in the department
• Communication and collaboration with all teams when needed
• Perform other duties or functions as assigned
• This position has limited to no face-time with patients but requires excellent phone etiquette

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Individuals must have knowledge of medical insurance, appointment scheduling process, front office workflow process, demonstrate ability to become proficient in required software and applications, and must demonstrate a thorough knowledge of clinical practices. Excellent communication and organizational skills, proficient on most software applications in a windows environment and be able to perform each essential duty satisfactorily are required. Ability to type at least 35 words per minute with an error rate less than 2%. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION and/or EXPERIENCE

One-year certificate from college or technical school; or three to six months related experience and/or training; or equivalent combination of education and experience.

Previous experience in a call center or in a medical office with significant phone usage is preferred.

LANGUAGE SKILLS

Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.

MATHEMATICAL SKILLS

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate and percentage.

REASONING ABILITY

Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee frequently is required to stand and walk. The employee is occasionally required to stoop, kneel, crouch, or crawl. Specific vision abilities required by this job include ability to adjust focus. Ability to lift up to 20 lbs.