Insurance Eligibility Specialist


 

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Share Our Selves (SOS) is proud to be the largest Federally Qualified Health Center in Orange County to combine wrap-around social services with health care. We have 6 community health centers in Costa Mesa, Newport Beach, Anaheim, Santa Ana and Mission Viejo.

Starting pay rate will depend upon experience, education and skills within our pay range.

Responsibilities:

  • Verifies insurance benefits on all patient appointments on payer portals or by calling payors to determine level of insurance coverage.
  • Identifies correct payer plans within the practice management system to add coverage to accounts.
  • Documents accurate demographics into practice management system
  • Maintains insurance error work queues within practice management system.
  • Responds to insurance eligibility questions from clinic staff timely.
  • Assist patients on PCP and network changes, if necessary, prior to appointment
  • Calls patients to obtain insurance information if lapsed or missing.
  • Notifies supervisor of any system errors including Real Time Eligibility (RTE) being down
  • Coordinates with and provides feedback to supervisor on process improvements, trends, errors, or issues as related to the registration process by clinic/user.
  • Other duties as assigned.

Skills:
- Strong attention to detail and accuracy
- Excellent organizational and time management skills
- Effective communication skills, both written and verbal
- Ability to work independently and as part of a team

Experience/Education:

  • High School Diploma/GED
  • Minimum of two (2) years of insurance eligibility & patient registration experience in a healthcare setting, preferably FQHC/Community Health Clinic
  • Knowledge of health insurance verification requirements and processes
  • Knowledge of payer specific guidelines including Medi-Cal, Medicare, Commercial, HMO, and managed care
  • Knowledge of health insurance benefits including medical, dental, and behavioral health
  • Experience in Electronic Health Record system, Epic preferred
  • Strong computer skills, proficiency in data entry and Microsoft programs such as Word, Excel, Outlook, Teams and Internet.
  • Must have excellent customer service skills, good energy and a positive attitude.
  • Requires strong typing and computer skills in a windows environment with strong attention to detail.
  • Bilingual in English and Spanish required

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What do we offer? A competitive salary and a generous benefits package for our full time team members which includes Health Insurance options covered at 100% or 90% of cost for team members and 50% for eligible dependents; We have group Medical, Dental and Vision, Flexible Spending Accounts, Basic Life insurance/AD &D, Voluntary Life Options, Long Term Disability, 403b Retirement Plan with employer match, Employee Assistance Program, Global Travel Assistance, Supplemental Accident, Critical Illness and Hospitalization plans offered, Tuition Reimbursement Program, 10 Paid Holidays, 10 Paid Vacation days and up to 6 paid Sick days per year.

All qualified candidates will be subject to an employment/criminal background check and must be able to provide proof of required vaccinations which include: Current TB Test, MMR, Annual Flu vaccination, COVID Vaccine/Booster or waiver. SOS will provide vaccines to new employee's if needed at no cost.

Job Req#202307IES-1 #202307IES-2

Job Type: Full-time

Pay: $17.50 - $21.00 per hour

Benefits:

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

Schedule:

  • 8 hour shift
  • Monday to Friday

Ability to commute/relocate:

  • Newport Beach, CA 92660: Reliably commute or planning to relocate before starting work (Preferred)

Experience:

  • Insurance verification: 2 years (Preferred)
  • Patient Registration: 2 years (Preferred)

Language:

  • Spanish (Preferred)

Work Location: In person

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