Find & Apply For Enrollment / Eligibility Specialist Jobs in Tupelo, Mississippi

JOB SUMMARY

The Insurance & Admission Specialist at North Mississippi Health Services is responsible for facilitating patient admission and discharge. This role operates under the guidance of the Office Coordinator and requires an experienced individual with strong organizational and communication skills to serve as a welcoming information source for patients, collect insurance details, paperwork, and payments, coordinate financial counseling and patient scheduling, and maintain accurate and comprehensive records to support efficient patient processing and a high quality patient experience. |

JOB FUNCTIONS

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Customer Service:

• Greets patients in a positive, helpful, and courteous manner.
• Explains paperwork such as patient rights, financial responsibility, charity application, medical releases, etc.
• Answers and disperses intra and/or inter departmental phone calls and messages.
• Promotes good intra and inter departmental and public relations.
• Responds to inquiries from patients, family members and providers in regard to health benefits.
• Assists patients in the Indigent Drug Programs by selecting programs, completing and submitting the enrollment forms and the receipt of shipments.

Admission:

• Obtains and/or verifies insurance eligibility and benefits.
• Gathers required signatures on patient paperwork.
• Interviews patient or patient representative in person or over the telephone to obtain demographics and insurance information.

Discharge:

• Remains responsible for discharging patients.
• Performs cashiering duties.
• Receives payments on accounts.
• Schedules appointments and procedures.
• Provides financial counseling to patients and/or patient representatives to manage balances owed.
• Assists patients and/or patient representative in completing the Charity Application for financial assistance.
• Takes responsibility for accurate documentation (coding) of diagnosis and therapy administered.
• Provides financial folders of each patient to the Business Office.

Record Keeping:

• Processes, maintains, and scans records in a timely, accurate, and confidential manner.
• Electronically updates patient's records.
• Submits patient information/documentation timely and accurately to the appropriate department.
• Complies with all HIPPA Regulatory and Insurance policies in gathering and maintaining patient records; reports possible non-compliant cases to Supervisor, Department Manager, or Compliance Officer.
• Records patients insurance and demographic information.
• Expedites billing and payment processes by receiving, interpreting, and submitting all necessary information and documentation in an accurate and timely manner.

QUALIFICATIONS

Education Education Level Education Details Required/Preferred High School Diploma or GED Equivalentor equivalentRequired And Associate's Degreein Business or related fieldPreferred Licenses and Certifications Licenses and Certifications Licenses and Certifications Details Time Frame Required/ Preferred Work Experience Number of Years Work Experience Details Required/ Preferred 1-3 years2 years of health care insurance, benefits, or collection experienceRequired Knowledge Skills and Abilities Knowledge, Skills, Abilities Required/Preferred Proficiency Excellent verbal and written communication skills; required.

RequiredN/AWorking knowledge of computer skills; required.

RequiredN/AKnowledge of pharmacy and infusion therapy (drugs, supplies, pumps), preferred.

PreferredN/AKnowledge of Diagnosis-Related Group (DRG) and coding, preferred.

PreferredN/AMust be able to resolve member, provider, and client complaints regarding reimbursement issues.

RequiredN/AMust be able to calculate and collect patient co-pays and/or co-insurance monies.

RequiredN/AMust be able to efficiently and accurately complete admission/discharge process.

RequiredN/AMust ensure compliance of departmental, regulatory, and HIPPA policies and procedures.

RequiredN/AMust be able to identify problems/errors with drug vs. therapy admissions and propose possible solutions.

RequiredN/AMust possess strong organizational and interpersonal skills.

RequiredN/AMust provide customer service to infants, pediatrics, adolescents, adults and geriatrics.

RequiredN/AMust be detail oriented.

RequiredN/AMust work well within a team-oriented structure.

RequiredN/AMust serve as a patient advocate.

RequiredN/AMust be able to gather and share information with knowledge, tact, and diplomacy.

RequiredN/AMust maintain patient confidentiality and adhere to HIPPA regulations.

RequiredN/AMust identify and report problems outside the established parameters to the supervisor, along with recommendations for solutions.

RequiredN/AMust make decisions that are conductive with the hospital's overall Mission/Vision Statements.

RequiredN/AMust comply with various legal and regulatory guidelines.

RequiredN/AMust make decisions regarding ordering of supplies, notifying nurses of exceptional cases, and customer service functions.

Required

N/A SCOPE

Freedom To Act:

Problem Solving:

Impact:

Financial Responsibility:

Sales Revenue Target Responsibility:

Approval Responsibility:

P & L Responsibility:

Assets Controlled:

• Controllable Expenses (e.g., Payroll and other budgeted items):

Total Financial Responsibility:

Budget Responsibility

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Shared Budget Responsibility:

_We believe a career is more than just a career - it's a calling. Our teammates' \"True North\" is what calls them to health care; it's their passion. At North Mississippi Health Services, we believe in helping you leverage and connect that passion with a much greater purpose that impacts people you know and love._ #NMHSConnections