Eligibility coordinator

Job Description

While professional experience and qualifications are key for this role, make sure to check you have the preferable soft skills before applying if required.

The position of Eligibility Verifications Coordinator performs eligibility request data entry and transmits scheduling responses to provider offices.

This role provides support directly to the eligibility team by communicating error logs and facilitating / communicating additional information requests from providers and / or patients.

This role monitors inbound and outbound calls / faxes to provider offices to obtain and data enter patient demographic and insurance data.

Responsibilities :

• Processes documents via facsimile and email; handles high level of incoming / outgoing faxes.
• Data entry with patient demographic and insurance information into Prime MSO Web App.
• Expedite and follow-up on verifications lifecycle, as needed.
• Transmit documentation to necessary parties via email, facsimile, or mail, in accordance with all medical practice regulations, such as, but not limited to HIPAA / HITECH.
• Digitally files inbound records into organizational drives for interdepartmental access in accordance with company policies and procedures.
• Coordinates with physician offices and educates prospective patients on benefits / scheduling with Prime.
• Performs insurance verifications.
• Manages monthly re-verification entry and facility communication.
• Maintains strict confidentiality, adhering to all HIPAA guidelines and regulations.
• Performs additional duties assigned by management.

Skills and Qualifications :

• Ability to read and comprehend instructions, detailed correspondence and memos.
• Ability to write correspondence.
• Ability to provide excellent customer service.
• Proper telephone etiquette.
• Strong written and verbal communication skills.
• Ability to manage a multiple line phone system.

Requirements :

• 1-year prior clerical experience.
• Proficient in MS Office programs (i.e., Word, Excel, Outlook, and Power Point).
• Department of Justice Background Check.
• Satisfactory Completion of Health / Drug Screening.
• Proof of legal US work eligibility.

Company Description

Since 2014, Prime MSO has developed and managed surgical facilities that provide patients with the highest level of surgical care.

Today we are one of the reliable and independent operators of outpatient surgery centers in the Los Angeles area, covering virtually the full range of surgical specialties.

Our remarkable community of teammates, physician partners and health system partners are deeply committed to providing quality patient care and improving healthcare in America.

Our focus on building strategic relationships with our partners enables us to acquire, develop and optimize facilities in an aligned economic model that enables better access to high-quality care at a lower cost.

While healthcare is in a constant state of change, we want to make sure it is always for the better. We believe that happier, more fulfilled employees and staff in a fun and dynamic work environment will ultimately provide the best care in the country.

At Prime MSO, that means success. Talk to any of our employees about their experiences and hear the difference Prime MSO is making in their lives today.

Benefits

• Health insurance
• 401(k) match
• Dental insurance
• Disability insurance
• Life insurance
• Paid time off
• Vision insurance
• Paid holidays
• Bereavement leave

Workplace Benefits :

Prime believes in fostering a rewarding and caring workplace environment. We understand the importance of work-life balance and appreciate the time our employees invest in us.

To show our appreciation, we strive to create a fun environment. We celebrate all staff birthdays and major life events.

We have at least two company-wide events each year including Derby Days where all Prime staff are invited to attend a fully paid for trip to racing tracks on a race day and a Holiday party usually at an upscale restaurant in downtown LA.

We celebrate holidays at individual locations throughout the year including potlucks for Thanksgiving and Secret Santa or White Elephant events during winter.

Working at Prime is like working with your closest friends and family.

We also strive to give back to our community. We proudly host food drives, toys for tots, and raise money for local charities in our area.

When creating and conducting these charitable events, we always choose local charities where we can see where the charitable efforts in action.

To promote good work-life balance, we have adopted a competitive PTO policy where all first-year full time employees accrue 14 total days of PTO (almost three weeks of paid time off).

The number of PTO days able to accrue increases with each year of employment too. We offer 48 hours of paid sick time to all full-time employees with part-time and even per diem employees able to accrue paid sick time based on hours worked.

We also offer paid bereavement leave in the event of a close family member passing away.

Vision and Dental insurance are fully paid for by the company. We offer generous contributions to all medical health plans with increased contribution to managers.

Our medical plans offered include HMO and PPO options with infertility coverage. As a Prime employee, you also have unique access to our surgical facilities and doctors for health needs as Prime strongly believes in the importance of access to good and affordable medical care.

Prime strongly values continued education and training for our employees. We assist our nursing staff in obtaining certifications when necessary and offer a tuition reimbursement program.

We offer cross-training at our facilities so our employees can broaden their knowledge, skill, and experience. We believe in the importance of meeting your full potential and do all we can as a company to help you achieve it.

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Last updated : 2024-09-28