Eligibility & Benefits Specialist

Horizon Health and Wellness, Inc. has offered quality healthcare services to central and southern Arizona for over 40 years. Our mission is to enhance the quality of life of the individuals, families and communities we serve, and empower them to attain their optimum potential. Our most important organizational philosophy is Kindness Matters. It is how we do our business and an essential component in all of our interactions with our patients and with each other.

We offer:

• Professional development and career advancement opportunities
• Competitive compensation
• Medical, dental, vision insurance
• 401k investment plan with company match
• Generous paid time off and paid holidays
• Tuition reimbursement
• The opportunity to help us make a difference in the lives of the patients and communities we serve.

The Eligibility & Benefits Specialist serves as a resource for patients by providing clear information about their insurance benefits, explaining coverage limitations and exclusions, and assisting with arranging alternative financing options when needed. The position assists patients with applying for or reinstating coverage for Medicaid through Arizona Health Care Cost Containment System (AHCCCS) when applicable. The Eligibility & Benefits Specialist enters and updates patient benefit information in the agency’s management information system with accuracy and attention to detail. The individual verifies insurance coverage with carriers both online and by phone. 

Qualifications Required        

• High School diploma or GED plus 3 years related experience; Demonstrated knowledge of EHR functionality, including accurate data entry, document management, eligibility verification, and navigation of system features to support efficient workflow and compliance.
• Must be at least 21 years of age or older.
• Understand and maintain confidentiality in accordance with Agency policies.
• Ability to work with minimal supervision.
• Ensure data entry and research tasks are completed accurately, in a timely manner, and in accordance with established procedures
• Demonstrate the ability and willingness to work effectively with diverse populations.
• Maintain flexibility and willingness to work evenings, weekends, and on an emergency basis as needed.
• Working knowledge/familiarity with computers and electronic clinical record keeping.
• Knowledge of Medical Terminology and familiar with insurance billing procedures.
• Must obtain and maintain a fingerprint clearance card and pass a background check.

Mental and Emotional

• Mental and emotional requirements include prioritizing workload, decision-making ability, using sound judgment to field inquiries concerning administrative, clinical, and operational concerns and ability to greet and deal effectively with participants, families, staff, and facility visitors.

Physical

• Long periods of sitting, ability to bend, lift and carry up to 20 pounds, do filing and move equipment.
• Able to operate phone, Fax, copier, and a computer.

Qualifications Preferred       

• Prior office experience in a behavioral health setting.
• Prior Behavioral Health insurance verification experience.
• Bilingual - English/Spanish.