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CP
Coastal Plains Integrated Health
Reimbursement Specialist
Career Insights for Eligibility Specialist
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Based on Texas 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.
$46,315 / year median in Texas
+19% projected growth
Job Description
Job Summary We are seeking a dedicated Reimbursement Specialist to join our dynamic team in Portland Tx. Responsibilities This position performs complex reimbursement work that involve billing, payments, and appeals for Medicaid, Medicare, Third party payers and consumers.
Specifically:
- Reviewing, posting insurance payments, write offs, and denials in the billing system.
- Distributing reports to clinical staff
- Verifying patient insurance status. Entering insurance information in billing system.
- Compiling, sorting, and verifying accuracy of data to be entered (service logs, financial assessments, insurance information) Obtaining further information for incomplete/erroneous documentation
- Acquires insurance authorizations for services.
- Reviews and resolves problems related to EVV billing Assists the billing department with
- Credentialing applications for enrollment with insurance companies.
- Configuring the billing system to accommodate changes
- Generating and shipping insurance claims
- Analyzing and reporting barriers to collections.
- Training of staff in the financial assessment process.
- Prepares financial reports for management.