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JFCS is seeking a detail-oriented professional to join our team in a role focused on supporting patients and ensuring a smooth process for accessing healthcare services. This position involves working closely with patients, insurance providers, and internal teams to help ensure information is accurate and services are appropriately coordinated.
- Obtains and updated copies of patients' insurance cards and demographic information.
- Determines and verifies patient insurance eligibility, benefits, and coverage for AHCCCS, Medicaid, Medicare and third-party insurance coverage.
- Engages with patients to determine if services requested need prior authorization.
- Submits authorization requests and tracks approvals to ensure timely patient care.
- Communicates with insurance companies to resolve authorization issues and claim denials.
- Maintains accurate patient insurance records in the electronic medical record (EMR) system.
Qualifications
- Previous experience as an Eligibility Specialist and demonstrated ability to manage multiple insurance plans including third-party insurance, AHCCCS, Medicaid and Medicare plans.
- Capacity to work with clinical staff, providers and follow payer guidelines and HIPAA regulations
- Ability to work in a fast-paced environment and provide excellent customer service and maintain documentation accuracy.
- Bilingual Strongly Preferred
- Must Receive/Maintain DPS Fingerprint Clearance
- High School Diploma or GED
- Must be able to perform the essential functions of the job including prolonged sitting and in certain positions driving, lifting 20lbs, walking, standing, and executing dexterity with a keyboard or smart pad.
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