ELIGIBILITY SPECIALIST - Public Health
Screens new and returning clients for financial eligibility for services. Applies insurance rules and interprets coverage for public health services. Evaluates income and financial assistance documents to determine fees for uninsured clients. Makes referrals for other resources in the community as needed. Ensures all eligibility and billing documentation entered in the electronic health record is accurate and timely.
THIS POSTING MAY CLOSE AT ANY TIME ONCE A
SUFFICIENT NUMBER OF APPLICATIONS HAVE BEEN RECEIVED
Tarrant County employees enjoy superior health, retirement, and insurance benefits.
For more information, please click on the link below:
http://www.tarrantcounty.com/en/human-resources/employee-benefits.html
• Obtains, verifies, and calculates income and resources to determine client financial eligibility.
• Proactively identifies and resolves enrollment and credentialing-related issues quickly to maximize revenue.
• Serves as a Medicaid Eligibility Advisor by assisting in the review, application, and completion of enrollment of eligible patients and account management as needed.
• Maintains insurance verification information in billing system.
• Reviews data on file for accuracy and updates as needed in a timely manner.
• Verifies all patient information and prior authorizations by calling employer or primary, secondary, and tertiary payers.
• Performs telephonic support for online authorization of routine services.
• Provides reports regarding utilization, authorization, and referral activities.
• Updates data in the electronic health record's patient scheduling for eligibility status prior to each appointment.
• Communicates with care providers concerning authorizations, denials, and appeals process information.
• Cross trains and serves as back up in areas of Business Services Insurance.
• Serves as a community resource liaison on the client’s behalf. Maintains community partner engagement through continuous communication and referrals as needed. Maintains resource registry for client resource access with current information.
• Performs other duties as assigned.
NOTE: YOU MUST FILL OUT THE WORK HISTORY and EDUCATION SECTIONS OF APPLICATION TO SHOW YOU HAVE YEARS OF EXPERIENCE/EDUCATION AS REQUIRED BY HIRING DEPARTMENT OR BE DISQUALIFIED.
• High school diploma or equivalent.
• Associate's degree preferred.
• Three (3) full-time years of hospital/medical business office experience with insurance procedures and patient interaction.
• One (1) full-time year of insurance precertification experience including navigating websites for online benefit reviews. Required years of experience can be concurrent.
• Bilingual English/Spanish preferred.
• Must have an understanding of patient confidentiality.
• Ability to collect, synthesize, and research complex or diverse information.
• Excellent computer, multitasking, and phone skills.
• Ability to work well under pressure with time sensitive documentation.
If hired, must provide proof of educational attainment at new hire processing.
Tarrant County will conduct background checks on new hires that will include a criminal background check related to convictions and deferred adjudications in the past seven years and may include credit reports, motor vehicle records, employment records and educational attainment. A conviction or deferred adjudication is not an automatic bar to employment. Each case is considered individually.
While performing the duties of this position, the incumbent is regularly required to bend, carry, climb, climb stairs, grasp/squeeze, use hand tools, hear, keyboard, kneel, lift below the waist, lift between waist and shoulder, lift overhead, lift to the side/twist, use material handling equipment, tolerate noise, pull, push, reach, reach overhead, perform repetitive tasks, see color, see far and near, sit, squat, stand, stoop, talk, use his/her hands, drive a vehicle, walk, and work alone and with others.
Apply Now
THIS POSTING MAY CLOSE AT ANY TIME ONCE A
SUFFICIENT NUMBER OF APPLICATIONS HAVE BEEN RECEIVED
Tarrant County employees enjoy superior health, retirement, and insurance benefits.
For more information, please click on the link below:
http://www.tarrantcounty.com/en/human-resources/employee-benefits.html
• Obtains, verifies, and calculates income and resources to determine client financial eligibility.
• Proactively identifies and resolves enrollment and credentialing-related issues quickly to maximize revenue.
• Serves as a Medicaid Eligibility Advisor by assisting in the review, application, and completion of enrollment of eligible patients and account management as needed.
• Maintains insurance verification information in billing system.
• Reviews data on file for accuracy and updates as needed in a timely manner.
• Verifies all patient information and prior authorizations by calling employer or primary, secondary, and tertiary payers.
• Performs telephonic support for online authorization of routine services.
• Provides reports regarding utilization, authorization, and referral activities.
• Updates data in the electronic health record's patient scheduling for eligibility status prior to each appointment.
• Communicates with care providers concerning authorizations, denials, and appeals process information.
• Cross trains and serves as back up in areas of Business Services Insurance.
• Serves as a community resource liaison on the client’s behalf. Maintains community partner engagement through continuous communication and referrals as needed. Maintains resource registry for client resource access with current information.
• Performs other duties as assigned.
NOTE: YOU MUST FILL OUT THE WORK HISTORY and EDUCATION SECTIONS OF APPLICATION TO SHOW YOU HAVE YEARS OF EXPERIENCE/EDUCATION AS REQUIRED BY HIRING DEPARTMENT OR BE DISQUALIFIED.
• High school diploma or equivalent.
• Associate's degree preferred.
• Three (3) full-time years of hospital/medical business office experience with insurance procedures and patient interaction.
• One (1) full-time year of insurance precertification experience including navigating websites for online benefit reviews. Required years of experience can be concurrent.
• Bilingual English/Spanish preferred.
• Must have an understanding of patient confidentiality.
• Ability to collect, synthesize, and research complex or diverse information.
• Excellent computer, multitasking, and phone skills.
• Ability to work well under pressure with time sensitive documentation.
If hired, must provide proof of educational attainment at new hire processing.
Tarrant County will conduct background checks on new hires that will include a criminal background check related to convictions and deferred adjudications in the past seven years and may include credit reports, motor vehicle records, employment records and educational attainment. A conviction or deferred adjudication is not an automatic bar to employment. Each case is considered individually.
While performing the duties of this position, the incumbent is regularly required to bend, carry, climb, climb stairs, grasp/squeeze, use hand tools, hear, keyboard, kneel, lift below the waist, lift between waist and shoulder, lift overhead, lift to the side/twist, use material handling equipment, tolerate noise, pull, push, reach, reach overhead, perform repetitive tasks, see color, see far and near, sit, squat, stand, stoop, talk, use his/her hands, drive a vehicle, walk, and work alone and with others.
Apply Now