What are the responsibilities and job description for the D201 - Eligibility Specialist position at River Edge Behavioral Health?
About River Edge Behavioral Health
Serving more than 10,000 Georgians, River Edge continues to be one of the state's leading resources for mental health, substance use disorder treatments and supports as well as individuals with intellectual and development disabilities. River Edge offers outpatient services at our Emery Highway-Macon, Monroe County and Baldwin County locations. Outpatient services include behavioral health, nursing, and psychiatric assessment, stabilization and medication maintenance services as well as crisis intervention services as well as awareness, education and recovery groups.
River Edge Behavioral Health is actively seeking an Eligibility Specialist to join our dedicated team, ideally possessing attention to detail, strong analytical skills, effective communication, a team player mentality, adaptability, problem-solving abilities, ethical conduct, and organizational skills.
Schedule: Monday to Friday: 8:30am- 5:00pm
FLSA Classification: Hourly, Non-Exempt
Benefits Offered
Interpersonal Excellence: Exceptional interpersonal skills to cultivate positive relationships with patients and colleagues, fostering a collaborative work environment.
Time Management Proficiency: Effective time management abilities to prioritize tasks and meet deadlines in a fast-paced billing environment.
Insurance Verification Systems Proficiency: Demonstrated ability to navigate and utilize various insurance verification systems and databases such as Availity and GAMMIS effectively.
Electronic Health Record (EHR) Management: Proficient in using electronic health record (EHR) systems to accurately update and maintain patient records in compliance with regulatory requirements.
Knowledge of Healthcare Terminology: Proficiency in healthcare terminology and terminology specific to insurance verification and medical billing processes, enabling effective communication with healthcare professionals and accurate interpretation of patient records and insurance documentation.
Additional Information
The Application Process
We at River Edge believe every employee has a right to a safe work environment. Therefore, we require full vaccination of all employees. Getting the vaccine, frequently washing your hands, sanitizing common areas, and wearing your mask continues to be the most effective way to fight COVID-19.
Diversity and Inclusion
River Edge Behavioral Health is committed to creating a diverse and inclusive work environment and is proud to be an equal employment opportunity employer. All qualified applicants will receive consideration for employment regardless of race, color, religion, gender, gender identity or expression, sexual orientation, nationality, genetic make-up, disability, age, or veteran status.
Drug-Free Workplace
River Edge Behavioral Health is a drug-free workplace with a longstanding commitment to providing a safe, quality-oriented, and productive work environment. In compliance with the Drug-Free Workplace Act of 1998, all applicants must pass a satisfactory background clearance and pre-employment drug screen.
At Will Workplace
Employment with River Edge Behavioral Health is at will. At-will means your employment relationship with River Edge Behavioral Health or Affordable Business Solution is for an indefinite period and is subject to termination by you or River Edge Behavioral Health, with or without cause, with or without notice, and at any time.
EEOC Statement
River Edge Behavioral Health is an Equal Opportunity Employer: River Edge Behavioral Heath recruits qualified candidates for positions in its service area. It is the policy of River Edge Behavioral Health provide equal employment opportunities to all employees and applicants for employment and prohibits discrimination or harassment of any type without regard to race, color, sex, religion, national origin, age, disability, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
If you are looking for an opportunity to make life better and a strong desire for personal growth we encourage you to apply. We promptly review all applications. Highly qualified candidates will be contacted for interviews.
We are an equal opportunity employer and highly value diversity. We do not discriminate based on race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
All selected applicants must pass a satisfactory background clearance and pre-employment drug test.
Serving more than 10,000 Georgians, River Edge continues to be one of the state's leading resources for mental health, substance use disorder treatments and supports as well as individuals with intellectual and development disabilities. River Edge offers outpatient services at our Emery Highway-Macon, Monroe County and Baldwin County locations. Outpatient services include behavioral health, nursing, and psychiatric assessment, stabilization and medication maintenance services as well as crisis intervention services as well as awareness, education and recovery groups.
River Edge Behavioral Health is actively seeking an Eligibility Specialist to join our dedicated team, ideally possessing attention to detail, strong analytical skills, effective communication, a team player mentality, adaptability, problem-solving abilities, ethical conduct, and organizational skills.
Schedule: Monday to Friday: 8:30am- 5:00pm
FLSA Classification: Hourly, Non-Exempt
Benefits Offered
- Competitive Pay
- Medical, Dental, Vision Insurance
- Paid Time Off
- 12 Paid Holidays
- 401k with an employer match
- Flexible Spending Accounts
- Short and Long-term disability coverage
- Life Insurance
- Employee Discount Program
- Verify all commercial insurance, Medicaid, Medicare, and state program coverage to determine patient responsibility.
- Ensure client records contain up-to-date payer information, including authorization, Connects, treatment plan, Intake Assessment, annual updates, financial application, ANSA, or CANS.
- Update all third-party payer information in the clinical record, as necessary.
- Obtain prior authorization (non-clinical), if required.
- Determine third-party liability and co-payment, if applicable, and update the clinical record accordingly.
- Maintain accurate and current payer information in the clinical record to facilitate timely submission to all payors.
- Provide assistance to front desk staff as needed regarding insurance co-payments and coinsurance questions.
- High School Diploma or GED.
- 2-3 years of knowledge and experience in third-party payer and insurance verification.
- Minimum of two (2) years of customer service experience in a medical office environment.
- Ability to thrive in a fast-paced work environment, with strong organizational skills to manage multiple tasks efficiently.
- All applicants must pass a satisfactory background clearance and pre-employment drug test.
- Provide two (2) Professional Reference Statements (Former employers only; no family members).
Interpersonal Excellence: Exceptional interpersonal skills to cultivate positive relationships with patients and colleagues, fostering a collaborative work environment.
Time Management Proficiency: Effective time management abilities to prioritize tasks and meet deadlines in a fast-paced billing environment.
Insurance Verification Systems Proficiency: Demonstrated ability to navigate and utilize various insurance verification systems and databases such as Availity and GAMMIS effectively.
Electronic Health Record (EHR) Management: Proficient in using electronic health record (EHR) systems to accurately update and maintain patient records in compliance with regulatory requirements.
Knowledge of Healthcare Terminology: Proficiency in healthcare terminology and terminology specific to insurance verification and medical billing processes, enabling effective communication with healthcare professionals and accurate interpretation of patient records and insurance documentation.
Additional Information
The Application Process
- All qualified applicants will be considered.
- This position is subject to close once a satisfactory candidate pool has been identified.
- The hiring managers will contact only those selected for an interview.
- Applicants who are not selected will receive notification via email.
- Due to the volume of applications received, we are unable to provide information on application status by phone or email.
We at River Edge believe every employee has a right to a safe work environment. Therefore, we require full vaccination of all employees. Getting the vaccine, frequently washing your hands, sanitizing common areas, and wearing your mask continues to be the most effective way to fight COVID-19.
Diversity and Inclusion
River Edge Behavioral Health is committed to creating a diverse and inclusive work environment and is proud to be an equal employment opportunity employer. All qualified applicants will receive consideration for employment regardless of race, color, religion, gender, gender identity or expression, sexual orientation, nationality, genetic make-up, disability, age, or veteran status.
Drug-Free Workplace
River Edge Behavioral Health is a drug-free workplace with a longstanding commitment to providing a safe, quality-oriented, and productive work environment. In compliance with the Drug-Free Workplace Act of 1998, all applicants must pass a satisfactory background clearance and pre-employment drug screen.
At Will Workplace
Employment with River Edge Behavioral Health is at will. At-will means your employment relationship with River Edge Behavioral Health or Affordable Business Solution is for an indefinite period and is subject to termination by you or River Edge Behavioral Health, with or without cause, with or without notice, and at any time.
EEOC Statement
River Edge Behavioral Health is an Equal Opportunity Employer: River Edge Behavioral Heath recruits qualified candidates for positions in its service area. It is the policy of River Edge Behavioral Health provide equal employment opportunities to all employees and applicants for employment and prohibits discrimination or harassment of any type without regard to race, color, sex, religion, national origin, age, disability, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
If you are looking for an opportunity to make life better and a strong desire for personal growth we encourage you to apply. We promptly review all applications. Highly qualified candidates will be contacted for interviews.
We are an equal opportunity employer and highly value diversity. We do not discriminate based on race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
All selected applicants must pass a satisfactory background clearance and pre-employment drug test.
