Job Description & Responsibilities

The overall purpose of this position is to facilitate eligibility verification and documentation for patients at Church Health. This includes eligibility for health insurance, as well as verification of existing health insurance. It also includes confirming eligibility requirements to be a patient at Church Health. This position will also serve as needed in the phone or front desk PSA role to provide patient services for patients who come to the Church Health Clinic for health care.

• Verify new patients meet Church Health eligibility requirements and documents are current and accurately stored in the EMR (Electronic Medical Record). As needed, facilitate annual eligibility re-verification and updating documentation. Eligibility verification includes, but may not be limited to:
  • Health Insurance Eligibility – Screen patients for eligibility to receive affordable health insurance such as Medicaid, Medicare, or Marketplace plans. Refer patients to HAT (Health Advisory Team) for assistance enrolling into insurance.
  • Residency requirements, working requirements, Income documentation – Verify patients meet requirements. Document approves exceptions and confirm annually if exceptions are still in place.
• Serve as a primary contact for CH staff who need help problem-solving patient eligibility requirements or documentation to facilitate treatment pathways.
• Coordinate verification of active health insurance coverage for scheduled patients.
• Work with additional PSA colleagues to ensure accurate insurance verification processes within phone and desk staff workflows.
• Serve as primary contact for billing staff to problem-solve insurance verification issues.
• This position is responsible for tracking special situations that allow patients to remain established at Church Health and be exempt from standard eligibility requirements.
• These include special relationship with other organizations like St. Jude and other social service agencies, as well as requested exceptions from CH staff.
• This position is responsible for confirming annually if the special situations are still present and communicating with CH staff, community organizations, and patients
• Assist supervisor in problem-solving, training, upkeeping training manual, and conveying useful information to teams.
• Responsible for taking on leadership role when supervisor is unavailable.
• Responsible for identifying areas of improvement in teams and conveying to supervisors.
• Responsible for exhibiting appropriate behaviors, attitudes, customer service and language.
• Responsible for helping supervisor foster a welcoming cohesive high-functioning team atmosphere.
• Answer and accurately route incoming calls from a multi-line phone system following established protocols.
• Schedule patient appointments over the phone.
• Provide reception at medical clinic desks.
• Checking patients in, receiving and processing documents, and collecting payments.
• Provide excellent customer service

Qualifications

• High School Diploma or GED

Special Skills & Knowledge

• Must be able to communicate effectively on the telephone, pay attention to details, have strong computer and data entry skills.
• Knowledge of HIPAA regulations, medical care codes and industry standards.
• Ability to deliver effective instruction and feedback, where appropriate, to PSA team members.