Eligibility Representative

TeamHealth is named among the Top 150 Places to Work in Healthcare by Becker's Hospital Review. Newsweek Magazine recognizes TeamHealth as ‘one of the greatest workplaces for diversity, 2024’ and TeamHealth is also ranked as ‘The World’s Most Admired Companies’ by Fortune Magazine. TeamHealth, an established healthcare organization is physician-led and patient focused. We continue to grow across the U.S. from our Clinicians to Corporate Employees. Join us.

What we Offer:

• Career Growth Opportunities
• Benefit Eligibility (Medical/Dental/Vision/Life) the first of the month following 30 days of employment
• 401K (Discretionary matching funds available)
• Generous PTO
• 8 Paid Holidays
• Equipment Provided for Remote Roles

JOB DESCRIPTION OVERVIEW:

This position is responsible working denial reports & correcting/refiling claims based on denial or rejection & eligibility responses. Must be able to note each patients account clearly so that all who need to review accounts will understand what has been done. Must be able to identify FSC according to eligibility website responses. Must be able to work from various source documents. This work is routine and repetitive.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Identifies appropriate FSC and insurance company
• Analyzes rejections & denials, identifies probable cause, and makes necessary corrections to refile claims
• Notes all Pt accounts that are worked to insure if review is needed in the future anyone would understand why/how it was refiled.
• Notifies seniors and/or supervisor of system malfunctions.
• Notifies senior and/or supervisor of problems arising from erroneous items, codes, or missing information.
• Performs any and all duties as directed by management.

QUALIFICATIONS / EXPERIENCE:

• High School diploma or equivalent required.
• Six months registration & eligibility experience.

PHYSICAL / ENVIRONMENTAL DEMANDS:

This job will be performed in a well-lighted and well-vented environment. Work is oriented around good visual skills. Eye fatigue may be encountered as extended amount of time is spent in front of computer.

This position may require manual dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, fax) and/or the ability to perform repetitive motions and/or meet production standards to comply with the essential functions. Also, may require physical and/or mental stamina to work overtime, additional hours beyond a regular schedule and/or more than five days per week.

Overtime may be required and can be mandated by Management.

DISCLAIMER:
Cooperative, positive, courteous and professional behavior and conduct is an essential function of every position. All employees must be able to work with others beyond giving and receiving instructions. This includes getting along with co-workers, peers and management without exhibiting behavior extremes. Job functions may require personal leadership skills such as conflict resolution, negotiating, instructing, persuading, speaking with others as well as responding appropriately to job performance feedback from the supervisor. Additionally, the information contained in this job description has been designated to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this position.