Eligibility Representative

Career Growth Opportunities

A Culture anchored in a strong sense of belonging
Benefits (Medical/Dental/Vision) begin the first of the month following 30 days of employment
Generous PTO
8 Paid Holidays
Equipment Provided for Remote Roles

Overview

The Eligibility Representative is responsible for working denial reports and correcting or refiling claims based on denial or rejection and eligibility responses. This person will note each patient's account clearly so that all who need to review accounts will understand the documentation. The Eligibility Representative will also identify FSC according to eligibility website responses and will work from various source documents.

Essential Duties and Responsibilities

• Identifies appropriate FSC and insurance company
• Analyzes rejections and denials, identifies probable cause, and makes necessary corrections to refile claims
• Accurately note all patient accounts so that this information can be viewed and understood in the future
• Notifies the Sr. Representative and/or Supervisor of system malfunctions and problems arising from erroneous items, codes, or missing information
• Performs any and all duties as directed by management

Qualifications / Experience

• High School diploma or equivalent required
• 6 months or more of registration and/or eligibility experience