Eligibility/Enrollment Specialist

US-AZ-Phoenix
Job ID
2017-2588
# Positions
1
Category
Administrative/Clerical

Overview

Under the direct supervision of the Eligibility and Enrollment Coordinator, the Eligibility and Enrollment Specialist will provide intake and eligibility verification support necessary for the effective provision of services to clients at the Behavioral Health clinics.

Responsibilities

 

Generate scheduled intake reports for each Behavioral Health (BH) clinic.  Verify information on the Inquiry/Referral and re-verify AHCCCS and RBHA eligibility for every intake. Verify any TPL (third party liability) insurance and private insurance via telephone.  Prepare intake packets electronically, print and send remotely to the appropriate BH clinics for scheduled intake appointments. Enter all insurance information into NextGen.  

 

Verify AHCCCS/RBHA insurance eligibility for daily appointments for all BH clinics through agency processes. Follow the agency’s loss of AHCCCS process and work closely with the BH clinics Operations and clinical staff to ensure timely action.  Obtain required authorizations and/or work closely with the Claims Department.

 

Verify TPL and private insurance eligibility for daily appointments for all BH clinics through agency processes.  Obtain required authorizations and/or work closely with the Claims Department.

Qualifications

High school education or equivalent.  Some college business and/or computer courses desirable.

 

Previous work experience in a position requiring significant public contact, preferably in a medical office with knowledge of AHCCCS and RBHA, TPL and private insurance.

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