River Edge Behavioral Health
D201 - Eligibility Specialist
role 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 developmental 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.
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
Duties & Responsibilities
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.
Qualifications
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).
Competencies
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.
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.
EEOC Statement
River Edge Behavioral Health is an Equal Opportunity Employer: River Edge Behavioral Health recruits qualified candidates for positions in its service area. It is the policy of River Edge Behavioral Health to 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.
All selected applicants must pass a satisfactory background clearance and pre-employment drug test.
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role 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 developmental 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.
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
Duties & Responsibilities
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.
Qualifications
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).
Competencies
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.
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.
EEOC Statement
River Edge Behavioral Health is an Equal Opportunity Employer: River Edge Behavioral Health recruits qualified candidates for positions in its service area. It is the policy of River Edge Behavioral Health to 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.
All selected applicants must pass a satisfactory background clearance and pre-employment drug test.
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