Eligibility Screener - San Antonio, TX (Bilinigual)

Responsibilities

• Maintain the appropriate level of work activity according to work standards and establish work processes to ensure timely certification for eligibility programs.
• Retrieve and forward requested records and information, including medical records, insurance policy information, remittance advice, and itemized statements, to appropriate parties.
• Analyze, distribute, and follow-up on special requests and adjustments with hospital personnel.
• Maintain consistent proactive communication with the patient or patient representative throughout the eligibility process, keeping the patient informed of the account progress.
• Screen patients and/or patient representatives to determine potential eligibility for Third Party resources.
• Communicate effectively with physicians, case managers, social workers, and hospital business office staff on a daily basis to ensure questions are answered and issues are addressed.
• Educate patients and patient representatives of the eligibility requirements, application process, and verification requirements for applicable programs.
• Maintain a professional relationship with the patient and governmental agencies to ensure cooperation and compliance.
• Document pertinent patient information and all work activity in the appropriate systems dictated by company policies and procedures.
• Ensure accounts are processed in accordance to Eligibility Program standards, Client expectations, and all applicable federal and state regulations guidelines.
• Perform other duties as assigned by management.

Minimum Requirements

• A high school diploma or GED.
• Equivalent combination of education and relevant work experience will be considered.
• Previous experience in healthcare coverage, eligibility, or revenue cycle management preferred.
• Working knowledge of healthcare regulations, including HIPAA, FMLA, Medicare, and other applicable laws and guidelines.
• Knowledge of SSI/SSDI preferred.
• Proficient in Microsoft Office applications (Word, Excel, Outlook) and comfortable navigating multiple computer systems and databases.
• Strong data entry and documentation skills with a high degree of accuracy and attention to detail.

Core Competencies

• Excellent interpersonal, written, and verbal communication skills, with the ability to interact professionally at all levels.
• Proven customer service experience, especially in high-volume or fast-paced environments.
• Ability to manage multiple priorities effectively while maintaining quality and accuracy.
• Strong organizational and time-management abilities with a process-oriented mindset.
• Comfortable working independently and collaboratively in a team-focused environment.
• Skilled in handling confidential and sensitive information with integrity and discretion.
• Bilingual in Spanish.

Work Environment & Schedule

• Ability to adapt to a flexible work schedule, including evenings and weekends, as needed.
• Demonstrated ability to thrive in a fast-paced, multitasking environment while meeting performance metrics and service level expectations.
• Strong presentation and active listening skills to effectively engage with patients and team members.
• Office-based role requiring long periods of sitting and regular use of standard office equipment (PC, phone, keyboard, etc.).
• Occasional lifting may be required up to 25 lbs.
• Must be able to sit for extended periods of time with frequent bending and stooping.