Eligibility Specialist

Eligibility Specialist

NaphCare has an excellent opportunity for an Eligibility Specialist to join our Corporate Headquarters in Birmingham, AL supporting our correctional health care clients. This position is on-site.

The successful Eligibility Specialist will play a critical role in our operations by reviewing inmate eligibility and authorizations for medical procedures/appointments and reconciling claims. This position requires data entry skills and the ability to maintain a high volume of work with minimal errors. This employee will verify eligibility and serve as a liaison between the scheduling and claims department to assist with timely processing of claims.

Responsibilities

Key responsibilities include and may not be limited to:

• Review inmate demographics in patient management programs to verify eligibility for various dates of service.
• Utilize healthcare experience to consistently review medical authorizations in our scheduling system in order to resolve outstanding claims
• Demonstrate skills in accuracy and multitasking while working to impact progress within the daily workload and adhere to internal deadlines
• Maintain confidentiality when managing medical records, patient data, and NaphCare processes
• Demonstrate a high comfort level in working with large volumes of data
• Demonstrate a strong attention to detail
• Additional duties and specific projects as assigned

Qualifications

Qualifications:

• High School Diploma or higher
• One (1) year minimum experience in a healthcare or claims setting
• Ability to prioritize and meet deadlines is critical in this role
• Working knowledge of medical terminology
• Strong written, verbal and organizational skills
• Working knowledge of claim demographic information
• Computer skills, including proficiency in Microsoft Office Suite, with an emphasis on Excel
• Must have the ability to maintain confidentiality of all proprietary and/or confidential information and integrity, professionalism and ability to adhere to a Code of Conduct and comply with all corporate policies, procedures, and legal requirements
• Must pass a criminal background check and drug screening

Working Conditions:

• Ability to manage workload during payroll periods and deadlines
• Long periods of sitting at a desk including working at a computer terminal.
• Light physical work involving lifting and carrying.
• Talking and listening to communicate ideas or requirements to individual staff members.
• Visual acuity to listen attentively and accurately.
• Ability to work overtime as needed to complete general responsibilities to meet the needs of the department

Why Join NaphCare?

At NaphCare, we believe in innovating to improve lives. We partner with local, state and federal government agencies to provide innovative healthcare, technology and administrative solutions for complex problems within the correctional and justice systems. Our success has always been due to our people and our commitment to treating every patient with dignity. We are mission-driven with a singular aim of improving lives through caring health care solutions provided in an environment of respect. United by this belief, we work as a team to improve each and every life we touch. Join our team of compassionate trailblazers who are dedicated to making a difference.

NaphCare Benefits for Full-Time Employees Include:

• Health, dental & vision insurance that starts day one!
• Prescriptions free of charge through our health plan, beginning day one
• Lowest Cost Benefits!
• Employee Assistance Program (EAP) services
• 401(k) and Roth with company contribution that starts day one
• Tuition Assistance
• Referral bonuses
• Term life insurance at no cost to the employee
• Generous paid time off & paid holidays
• Free continuing education and CMEs

If you would like to speak with me to learn more about this position and NaphCare, apply directly to the position to initiate the application process, and I'll be in touch.

Equal Opportunity Employer: disability/veteran