Texas Retina Associates is Texas’ largest, most experienced ophthalmology practice focused specifically on the diagnosis, medical and surgical management of diseases of the retina and vitreous. Our fellowshipped and specialty trained physicians care for the most complicated retina conditions such as ocular cancer and uveitis. This physician owned medical group provides services at 15 locations throughout the DFW metroplex, Waco, Wichita Falls and Lubbock.

Job Purpose

This position will be located in the Dallas Main Office and will provide support services for all 15 locations. The position will report directly to the Revenue Cycle Director. The Eligibility Specialist is responsible for payer and patient account authorizations, prior authorizations, predeterminations, insurance verifications that are obtained in a timely and decisive manner and answering routine and non-routine account inquiries. Follows standard procedures and pre-established guidelines to complete tasks.

Essential Duties

• Verification of insurance, coordination of benefits and prior authorization as needed.
• Work directly with insurance representative to confirm all claims and submit successfully to ensure payments are being processed in a timely manner.
• Work with co-workers to resolve insurance errors.
• Contacts patients to verify patient demographics and insurance providers, updates information in systems, and documents conversations.
• Answers patient insurance questions and resolves complaints.
• Participate in the implementation of procedures to improve the quality of work being processed.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below represent the knowledge, skill and /or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

Minimum Education and Experience

• High School diploma or equivalent required.
• Minimum two (2) years combined medical insurance authorization and verification experience required.
• Demonstrate knowledge of state, federal, and third-party claims processing required.
• Demonstrate knowledge of state & federal collections guidelines.
• Experience with NextGen preferred.
• Must successfully complete required training within 90 days of occupying position.

Skills and Specifications

• Work under minimum supervision and demonstrate strong initiative.
• Make independent decisions when circumstances warrant; make prompt and accurate judgments.
• Excellent communication with physicians, patients and staff is required.
• Must be articulate in English speech, writing and understanding.
• Strong ability to listen, answer all questions as simply as possible and act when needed to resolve issues.
• Excellent organization skills; solid attention to detail to ensure accuracy of information
• Proven analytical skills; recognize, evaluate, solve problems, and correct errors, and develop processes that eliminate redundancy
• Use independent judgement to escalate issues to manager as necessary.
• Must be willing to work under pressure.
• Excellent Microsoft Office Suite skills including Excel, Word, Outlook and Access
• Attend work as scheduled and/or required.
• Complete all other duties as assigned.

Job Type: Full-time

Pay: $17.00 - $20.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Education:

• High school or equivalent (Required)

Experience:

• Medical Insurance Authorization & Verification: 2 years (Required)
• Claims Processing (state, federal and third party): 2 years (Required)

Work Location: In person

Please Note :
ajayjain.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, ajayjain.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.