Eligibility Specialist (College of Medicine) - (492472 )

Department: Clinic Enterprise

Salary: 16.63-18.73

Description:

1. Determines applicant eligibility for third party reimbursement, processes data necessary for admission of new patients into health services, ensure proper coding for insurance billing, and handle inquiries from prospective applicants and patients.
   
   1. Conducts eligibility for clients following process and guidelines specific to each program.
   2. Participates in client recruitment and education in the community regarding services, programs and eligibility.
   3. Ensures that clients do not have another payer source such as Medicaid, Medicare, ADAP, and any other third-party insurance.
   4. Registers clients into applicable systems.
   5. Completes all necessary paperwork and performs data entry of eligible clients into electronic system.
   6. Maintains up-to-date and orderly eligibility files and conducts renewal eligibility as required by each program.
   7. Confirms eligibility appointments with clients and schedule appointments with potential clients.
   8. Sets initial service appointments once eligibility has been determined.
   9. Provides clients with list of required eligibility documentation.
   10. Works with administration to ensure appropriate collection of data for financial, operations, compliance, and quality reporting.
   11. Participates in quality improvement initiatives.
   12. Performs other job-related duties as assigned.
   
   MQ: Requires the ability and knowledge for analysis and interpretation of procedures, policies and practices attainable through specific education and/or training programs in a specialty or technical field. Advanced vocational or electronic skills or a basic knowledge of a professional field is required. An Associate's degree or certification/licensing in a technical specialty program of over 18 months and up to 3 years duration are characteristic of this field. Requires a minimum of three (3) year of directly job-related experience.
   
   Additional Job Posting Information:
   -Assist patients in enrolling in assistance programs to help eliminate barriers to care
   -Effectively and accurately reviews patient’s third party coverage benefits to determine patient financial responsibility and plan requirementsCounsels patients on matters related to insurance benefits, payment options, and/or collects past balances including bad debt.
   -Answers any questions posed by the patient related to a billing or financial concern.
   
   -Department is willing to accept education in lieu of experience.
   -Department is willing to accept experience in lieu of education.

All positions at the University of Houston-System are security sensitive and will require a criminal history check.

The policy of the University of Houston-System and its universities is to ensure equal opportunity in all its educational programs and activities, and all terms and conditions of employment without regard to age, race, color, disability, religion, national origin, ethnicity, military status, genetic information, sex (including gender and pregnancy), sexual orientation, gender identity or status, or gender expression, except where such a distinction is required by law.