Eligibility Specialist RideCare - 1.0 Norman, OK Job Details Full-time 2 hours ago Benefits Disability insurance Health insurance Dental insurance 401(k) Paid time off Employee assistance program Vision insurance 401(k) matching Professional development assistance Life insurance Qualifications Managed care Managed care organization experience Regulatory compliance in claims processing HIPAA High school diploma or GED Medicaid health insurance Medicaid regulations Medicaid Typing Medical terminology Documentation review Full Job Description Job Summary We are seeking a dedicated and detail-oriented Eligibility Specialist to join our team. In this vital role, you will be responsible for assessing consumer eligibility for various health programs, ensuring compliance with Medicaid regulations, and facilitating smooth access to essential services. Duties Verify consumer insurance coverage and benefits prior to appointments Prepare, review, and submit accurate insurance claims Review documentation to determine eligibility based on Medicaid, Managed Care Organizations, and other health insurance guidelines Utilize systems for data entry, managing electronic health records with precision and confidentiality Verify consumer information in accordance with HIPAA regulations while maintaining strict confidentiality Follow up on unpaid or denied claims, resolve discrepancies, and resubmit as needed Maintain detailed documentation of billing activities Generate billing and financial reports as requested Stay updated on Medicaid regulations, healthcare policies, and basic medical terminology to ensure compliance and accuracy Other duties as assigned by leadership Experience High school diploma or equivalent 5+ years of billing/insurance experience required Proven experience working in hospital settings or similar Knowledge of medical terminology and insurance processes, specifically with Managed Care Organizations and Medicaid Knowledge of Medicaid regulations and health insurance processes required Ability to handle sensitive information while adhering to HIPAA standards High proficiency in Microsoft 365 applications Tech-savvy, good typing skills, and data entry experience Ability to work independently to achieve results. Must originate, plan, and adapt to accomplish tasks Ability to set and maintain priorities when dealing with multiple demands and interruptions Expected hours: 40.0 per week

Benefits:

401(k) 401(k) matching Dental insurance Disability insurance Employee assistance program Health insurance Life insurance Paid time off Professional development assistance Vision insurance

Work Location:

In person