Insurance Eligibility Specialist at Pediatric Associates – San Pedro Garza García

PRIMARY FUNCTION: Verify insurance eligibility for future patient appointments, document eligibility notes and perform patient outreach as needed, providing excellent customer service

ESSENTIAL FUNCTIONS OF THE JOB: (This list may not include all of the duties that may be assigned.)

1. Follow Pediatric Associates Eligibility Verification Quality Checklist to determine insurance eligibility
2. Review patient insurance for future appointments and identify eligibility requirements based on health plan
3. Use all available resources to determine insurance eligibility (e.g. system, web portals, phone)
4. Update patient insurance details accurately
5. Identify eligibility issues, communicate them to patients/parents and accurately document action taken
6. Complete all assigned appointments efficiently, within the expected timeframe
7. Communicate with office location via e-mail, Microsoft Teams and/or phone to coordinate patient callbacks for appointment rescheduling
8. Communicate effectively with supervisor, escalating issues as needed
9. Meet productivity standards as determined

PERFORMANCE REQUIREMENTS:

Education: High School Diploma or equivalent.

Experience: 1-2 years experience preferred. Must be detail-oriented and able to efficiently complete a high-volume of tasks using many different sources. Excellent documentation skills required.

Typical Working Conditions: Working in a professional office environment. The position requires ability to sit for long periods of time. Clear and concise communication using e-mail and phone is necessary. May require sitting or standing for long periods, including stooping, bending & stretching. Requires, occasional lifting of files and boxes weighing up to 25 lbs. Requires manual dexterity sufficient to operate a keyboard, type at 35 wpm, operate copier, and other office equipment as necessary.