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Eligibility Specialist in Addison, TX at Jordan

Date Posted: 10/10/2018

Job Snapshot

Job Description

The Eligibility Specialist accurately and effectively reports Medicare and/or Insurance eligibility to intake and the billing department by obtaining insurance authorizations, and verifying eligibility and benefits as needed.

Position Duties and Responsibilities:  Component Proportion 80%


  • Processes and verifies Medicare and/or insurance eligibility

  • Effectively provides administrative management of commercial insurance patients (benefit verification, reauthorization, scheduling).

  • Tracks patient status, with assistance from the Marketing team, until patient is admitted.

  • Other duties as assigned.


Reporting/Planning:  Component Proportion 20%

  • Promotes effective, positive and respectful communication to patients, staff members, other healthcare professionals and referral sources.

  • Promotes agency vision and administrative policies by maintaining a high level of ethical standards.

  • Presents a professional image of self and agency as outlined in the employee handbook.

Other duties/projects as assigned.

Job Requirements


  • Must have a high school education or equivalent.

  • Working knowledge of Medicare/Medicaid home health care benefits, rules and regulations.

  • Minimum of one year general office experience.


•         Some knowledge of medical terminology preferred.

•         Have excellent knowledge of computers.

•         Have the ability to motivate others in a positive manner.

•         Have good verbal and written communication skills.

•         Possess well developed interpersonal skills.

•         Have the ability to organize work and schedule effectively.

•         Have the ability to think analytically.


  • Must have satisfactory references from previous employers.

  • Must be able to pass a criminal history check.

  • Must be able to pass a random drug test.

Must have a dependable vehicle and a valid driver’s license.