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Verifier
Career Insights for Eligibility Specialist
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Scorecard
Based on Oklahoma data
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What they do
An Eligibility Specialist provides assistance and information for people who apply for a government benefits program or health care program. Answers questions, assists with an application process, and reviews applications and relevant background information to determine eligibility. May assist eligible applicants with enrolling in a program.
$48,600 / year median in Oklahoma
+23% projected growth
Job Description
Verifier Emergency Medical Services Authority - 2.9 Tulsa, OK Job Details 1 day ago Qualifications HIPAA compliance Medical insurance coverage verification Medical office experience Patient demographics HIPAA High school diploma or GED Driver's License Data accuracy checks Full Job Description Minimum Qualifications Minimum GED or High School Diploma Minimum 2 years' experience in a hospital or physician's office entering and verifying patient demographics and insurance information. Knowledge of Health Insurance Portability and Accountability Act (HIPAA) Excellent time management skills with attention to detail. Ability to work independently and with a group and maintain good working relationships. Must possess a valid driver's license. Must be able to successfully pass a background check and drug screen to the satisfaction of the organization. Essential Functions of the Position Perform pre-verification for billing utilizing the tools and systems of the organization. Obtain and verify all demographic and payer information to be accurate, using appropriate sources and update as required for clean claim processing. Contact patient, patient representatives, or other responsible parties to obtain accurate information for billing. Obtain pre-authorization as needed for non-emergency transports. Process and sort correspondence related to patient accounts accurately. Appropriately document patient accounts in billing system to reflect accurate patient information, including updated demographic or insurance information. Maintain set quality and quantity productivity standards. Maintain knowledge of current industry standards and organizational practices and work in a manner that supports a patient centered, team focused, and fiscally responsible organization. Communicate with other team members and leaders on identified trends and process improvement opportunities. Conduct self in a professional manner that reflects the mission, vision, and values of EMSA. Adhere to all organizational policies and work with the highest level of integrity. Adhere to and enforce all safety standards and policies. Performs other duties as assigned. Punctuality and regular, predictable, reliable, consistent attendance is essential. Other essential functions include professionalism, the ability to communicate effectively (verbally and in writing), maintaining confidentiality, exercising sound judgment, being adaptable and flexible, following safety and compliance protocols, being accountable, complying with the Code of Conduct, organizational policies, procedures, practices, and expectations, and performing the core duties of the position either with or without a reasonable accommodation. Other Functions of the Position Performs other job-related duties, functions, tasks and responsibilities as assigned, which may vary based on evolving organizational needs and priorities. These responsibilities are not considered essential functions of the position and may be modified or reassigned to accommodate individuals with disabilities, in accordance with the Americans with Disabilities Act (ADA) as amended. Knowledge, Skills, Abilities, and Other Characteristics Proficient with Microsoft Office Suite Self-driven attitude with ability to meet organizational Ability to work independently and with a group and maintain good working Supervisory Responsibilities No supervisory responsibilities. Physical Demands Hearing and talking to interpret job functions are frequently required and frequent visual ability to judge distance and space and clarity up to 20 ft. Occasionally may need to lift pull or pull objects up to 25 lbs. in all directions. Work Environment Work is generally performed in an office setting sitting at a desk for prolonged periods with frequent repeating motions that may include wrists, hands, and fingers. Limited exposure to external environmental conditions, such as heat, cold, rain, snow and ice. Frequently required to meet deadlines, work with changing priorities, and assess the accuracy and completeness of work on a regular basis. Frequently use logic to analyze and problem solve difficult situations and communicate to express or exchange ideas using proper English grammar and spelling. Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.