Eligibility Specialist - Remote

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    "requisitionDescription": "<div><div><link href=\"https://static.workforcenow.adp.com/mas/mdf-components/22.3.26/styles/froala_editor.pkgd.min.css\" rel=\"stylesheet\" type=\"text/css\">&nbsp;<link href=\"https://static.workforcenow.adp.com/mas/mdf-components/22.3.26/styles/froala_style.min.css\" rel=\"stylesheet\" type=\"text/css\"><div class=\"fr-view\"><p id=\"isPasted\"><strong><span style=\"color: rgb(0, 0, 0);\"><span style=\"font-size: 14px;\"><span style=\"font-family: georgia, serif; font-size: 14px; color: rgb(0, 0, 0);\"><strong>Job Description:&nbsp;</strong></span></span></span></strong></p><p><span style=\"color: rgb(0, 0, 0);\"><span style=\"font-size: 14px; font-family: georgia, serif;\">Optim Orthopedics is seeking a full time Eligibility Specialist/Remote.&nbsp;</span></span></p><p><span style=\"font-size: 14px; font-family: georgia, serif; color: rgb(0, 0, 0);\"><strong><strong>Job Requirements:&nbsp;</strong></strong></span></p><ul style=\"list-style-type: disc;margin-left:undefined;\"><li id=\"isPasted\" style=\"font-size: 14px; font-family: georgia, serif; color: rgb(0, 0, 0);\">Reviews clinic schedules 48 hours in advance of appointment for designated locations and checks all eligibility and benefits to ensure patient insurance is active. &nbsp;Will be required to contact patient if there is an issue with their insurance in advance of the appointment.</li><li style=\"font-size: 14px; font-family: georgia, serif; color: rgb(0, 0, 0);\">Updates copay information in Athena and provides notes in the patient account for the front desk regarding co-insurance, deductibles due and collections of any balances due prior to patient&#39;s appointment.</li><li style=\"font-size: 14px; font-family: georgia, serif; color: rgb(0, 0, 0);\">Monitors eligibility bucket in EMR for upcoming appointments. &nbsp;Reviews the patient&#39;s insurance for eligibility and benefits.</li><li style=\"font-size: 14px; font-family: georgia, serif; color: rgb(0, 0, 0);\">Responsible for ongoing daily monitoring of EBT email group to assist Patient Access Coordinators with eligibility issues identified at the time of making the appointments.</li><li style=\"font-size: 14px; font-family: georgia, serif; color: rgb(0, 0, 0);\">Responsible for verifying that authorizations are obtained and attached to the appropriate appointment at the time of the visit to ensure claim is submitted correctly and accurately.</li><li style=\"font-size: 14px; font-family: georgia, serif; color: rgb(0, 0, 0);\">May assist Patient Account Coordinator as needed in setting up payment plans to help patients manage payment of bills.</li><li style=\"font-size: 14px; font-family: georgia, serif; color: rgb(0, 0, 0);\">May assist in identifying and communicate any trends, denial issues or irregularity impacting resolution of patient accounts or daily production workflow to supervisor and other team members and recommend resolution.</li><li style=\"font-size: 14px; font-family: georgia, serif; color: rgb(0, 0, 0);\">Must have a comprehensive understanding and knowledge of the insurance claim process, EOB and patient statement to assist patients as needed with questions.</li><li style=\"font-size: 14px; font-family: georgia, serif; color: rgb(0, 0, 0);\">Forwards any billing issues identified to the appropriate staff to assist patients with resolution.</li><li style=\"font-size: 14px; font-family: georgia, serif; color: rgb(0, 0, 0);\">Maintains up-to-date knowledge of third party billing and reimbursement, clinic&#39;s financial policies and industry knowledge.</li><li style=\"font-size: 14px; font-family: georgia, serif; color: rgb(0, 0, 0);\">Must maintain accuracy in demographic and data entry in the EMR system.</li><li style=\"font-size: 14px; font-family: georgia, serif; color: rgb(0, 0, 0);\">Uses electronic systems (email, Practice Management System and EMR) for communication to other staff members to have an accurate detail account in the patient record. &nbsp;Maintains professional and respectful documentation at all times in the patient record.</li><li style=\"font-size: 14px; font-family: georgia, serif; color: rgb(0, 0, 0);\">Responds to patient calls timely and professional and documents appropriately in the patient chart.</li><li style=\"font-size: 14px; font-family: georgia, serif; color: rgb(0, 0, 0);\">Completes annual compliance and regulatory requirements as applicable. &nbsp;Follows all work processes, procedures while maintaining compliance to the organizations rules and regulations.</li><li style=\"font-size: 14px; font-family: georgia, serif; color: rgb(0, 0, 0);\">Protects and keeps all patient information confidential following all HIPAA, state and federal laws. &nbsp;Upholds and promotes patient safety and quality.</li><li style=\"font-size: 14px; font-family: georgia, serif; color: rgb(0, 0, 0);\">Accepts ownership for all tasks and responsibilities while improving the company&#39;s reputation. &nbsp;Escalates any problems to the Manager or Supervisor as appropriate.</li><li style=\"font-size: 14px; font-family: georgia, serif; color: rgb(0, 0, 0);\">Demonstrates and encourages team behavior and exceptional patient/guest experiences.</li><li style=\"font-size: 14px; font-family: georgia, serif; color: rgb(0, 0, 0);\">May be required to serve as back up as needed for other Front Office positions for check in or check out.</li><li style=\"font-size: 14px; font-family: georgia, serif; color: rgb(0, 0, 0);\">Other duties may be assigned.</li></ul><p><span style=\"color: rgb(0, 0, 0);\"><span style=\"font-size: 14px;\"><span style=\"font-family: georgia,serif;\"><strong>Optim Offers:</strong></span></span></span></p><ul><li style=\"font-family: georgia, serif; font-size: 14px; color: rgb(0, 0, 0);\">Competitive Pay &nbsp; &nbsp;</li><li style=\"font-family: georgia, serif; font-size: 14px; color: rgb(0, 0, 0);\">Company Benefits &nbsp; &nbsp;</li><li style=\"font-family: georgia, serif; font-size: 14px; color: rgb(0, 0, 0);\">Paid Time Off &nbsp; &nbsp;</li><li style=\"font-family: georgia, serif; font-size: 14px; color: rgb(0, 0, 0);\">Holiday Pay &nbsp; &nbsp;</li><li style=\"font-family: georgia, serif; font-size: 14px; color: rgb(0, 0, 0);\">401K Plan &nbsp;&nbsp;</li></ul></div></div></div>\n",
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