(Archived) Eligibilty Support Representative

Purpose: The Eligibility Representative is responsible for ensuring that patient account information is accurate resulting in accurate estimations of benefits.

Essential Functions

* Manages inbound communication ensuring insurance information on patients is accurate.
* Verifies insurance plan set-up and insurance estimations through various reports.
* Runs and analyzes error reports, correcting patient-relationship and effective-date errors on accounts.
* Troubleshoots estimation and other questions from practices and home office employees through various communication sources.
* Inputs updates to allowable and other fee schedules into Practice View system.
* Attaches documentation to patient account so accurate plan benefits are reflected.
* May have responsibility for analyzing orthodontic accounts to ensure proper codes are used at time of service.
* Collaborates with CDM Analyst on allowable fee schedules.
* Other duties and projects as assigned.

Required Skills and Experience

Education/Experience

* High School Diploma required. Bachelors degree strongly preferred.
* 1-3 years revenue cycle experience required, dental (or healthcare) preferred.

Knowledge/Skills/Abilities:

This position requires that the candidates will embody the principles of our core valuesand demonstrate the aptitude in the following areas:

* Professional communication skills (verbal, listening and written); ability to tactfully present information in clear and understandable manner.
* Analytical ability; ability to analyze contracts, interpret metrics and understand workflows.
* Detail oriented focus; ability to work with complex claims.
* Flexibility; ability to adapt to change and willingness to take on new tasks.
* Proficient with technology; ability to utilize Microsoft Office applications, databases, EHR and practice management software, as well as, internet applications.
* Time management; ability to prioritize and efficiently process claims.
* Professional integrity; ability to work independently with a high level of professionalism, dedication and commitment.
* Resultsoriented; ability to meet deadlines and hold vendors accountable to service level agreements.
* Interpersonal and relationship building skills; ability to establish and maintain positive working relationships, internally and externally.

Work Environment

* Office with cubicle environment, head sets may be utilized, but not required.
* Fast-paced office work environment.

Independence, OH
Independence, Ohio