Eligibility Verification Specialist

Summary

Pediatric Associates was founded in Hollywood, FL in 1955. The same clinician-led, evidence-based, medical home passion is a unifying driver for those who join Pediatric Associates Family of Companies. The Pediatric Associates Family of Companies is a growing team of Pediatricians and Pediatric Care Teammates who are excited to be part of the first nationwide Pediatric Primary Care Medical Home. We further our uniqueness by ensuring the clinician voice is leading our medical home innovations.

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.)

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

PERFORMANCE REQUIREMENTS:

Education: High School Diploma or equivalent.

Language: Must be proficient in English and Spanish

Location: Monterrey, N.L., Mexico

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

Typical Working Conditions: Working in a professional office environment. Clear and concise communication using e-mail and phone is necessary. Requires manual dexterity sufficient to operate a keyboard, type at 35 wpm, operate copier, and other office equipment as necessary.

The Pediatric Associates Family of Companies an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.