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Eligibility Consultant

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Description:

  • The Eligibility Consultant processes to assist with processing, insurance verification and authorization, revenue cycle management, compliance and documentation, as well as customer service and issue resolution.
  • This person will provide support in ensuring accurate billing, efficient revenue flow, and compliance with regulations.
  • Handle physical documents and paper records to verify the eligibility of patients or members for healthcare services.
  • Review paper forms, applications, or supporting documentation to gather and validate information such as insurance coverage, demographic data, and eligibility criteria.
  • Organize paper-based eligibility documents by creating and maintaining filing systems, ensuring proper document storage, and implementing strategies to improve accessibility and retrieval of information.
  • Analyze the paper-based information and documentation to determine the eligibility of patients or members for healthcare services.
  • Perform manual data entry tasks to input eligibility information into relevant systems or databases.
  • Ensure compliance with relevant healthcare regulations, policies, and industry standards in relation to paper-based eligibility operations in order to maintain patient confidentiality.
  • Identify opportunities to enhance the efficiency and accuracy of paper-based eligibility operations.
  • Follow regular, timely feedback, as well as the formal performance review process, to ensure delivery of exceptional services and engagement, motivation, and personal development.
  • Generate reports and analyze data related to paper-based eligibility operations to help improve processes, address bottlenecks, and support decision-making.

Requirements:

  • 1+ year of experience with data entry.
  • Working knowledge of Microsoft Office products (Word, Excel, PowerPoint, Outlook).
  • Must reside in Phoenix, Arizona.
  • Demonstrated problem solving and decision-making skills.
  • Previous experience working with Medicare and Medicaid.
  • Ability to work successfully within a collaborative, team-based environment.
  • Strong communication skills.
  • Strong attention to detail.

Benefits:

  • Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

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