Eligibility Representative (PT24) position Tuesday-Saturday (Tuesday - Friday 1:00 PM - 6:00 PM and Saturday 8:00 AM - 12:00 PM or Wednesday - Friday 12:00 PM - 6:30 PM and Saturday 8:00 AM - 2:30 PM) for qualified individuals at Medical Center Enterprise in Enterprise, AL in the Eligibility Screening Services Department. ESS is an Equal Opportunity Employer

Job duties include:

• Responsible for maintaining performance standards that ensure the department is operating at peak proficiency and that established goals are consistently being met while maintaining effective communication with patients, physicians, medical office staff, and both internal and external co-workers.
• Calculates the estimated patient financial responsibility via the estimation tool.
• Notates all actions performed in the applicable host system(s) immediately.
• Communicates outstanding documentation requests, required account follow-up, and payor issues to the appropriate facility contacts.
• Performs all other duties, as assigned or requested, while adhering to strict deadlines
• Verifies detailed insurance benefits, medical necessity, and authorization/referral guidelines, consistently prioritizing and following the established verification processes.

• Providing point of service collections for self-pay patients, patients who have balances after insurance or Medicare payments, and patients that do not qualify for any programs/coverage.
• Screening referred self-pay patients for programs such as Medicare, Medicaid, Medicaid for nursing home placement, Crime Victims, vocational rehabilitation, QMB, SSI, and any/all other third party coverage including other available local, state, and federal programs in addition to the hospital’s financial assistance program

Minimum qualifications:

• Meet productivity standards ( there is a potential quarterly bonus structure in place for high performers )
• Proficiency in Microsoft Word and Excel
• At least 1 year of healthcare experience
• Bilingual in Spanish is preferred and additional compensation added
• Comply with hospital policies

Prior experience in collections and knowledge of HIPAA,EMTALA, and PHI are a plus.