Eligibility Screener/Healthcare Associate

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Requisition ID: 124198
Job Category: Call Center
Location: United States-California-Stockton-St. Joseph's Hospital and Medical Center
Posted Date: 9/11/2017 1:20:37 PM
Expert Global Solutions (EGS), an Alorica company, is a global customer service organization, serving the world’s leading companies and best-known brands. With more than 40,000 employees in locations around the world, our people deliver extraordinary service – via phone, email and chat, every day. Embracing a diverse workforce with a shared commitment to deliver outstanding customer service, EGS offers significant opportunity to build a rewarding career, in a dynamic and customer-oriented environment.
 
Principal Responsibilities
  • Maintain the appropriate level of work activity according to work standards and establish work processes to ensure timely certification for eligibility programs.
  • Retrieve and forward requested records and information, including medical records, insurance policy information, remittance advice, and itemized statements, to appropriate parties.
  • Analyze, distribute, and follow-up on special requests and adjustments with hospital personnel.
  • Maintain consistent proactive communication with the patient or patient representative throughout the eligibility process, keeping the patient informed of the account progress.
  • Screen patients and/or patient representatives to determine potential eligibility for Third Party resources.
  • Communicate effectively with physicians, case managers, social workers, and hospital business office staff on a daily basis to ensure questions are answered and issues are addressed.
  • Educate patients and patient representatives of the eligibility requirements, application process, and verification requirements for applicable programs.
  • Maintain a professional relationship with the patient and governmental agencies to ensure cooperation and compliance.
  • Document pertinent patient information and all work activity in the appropriate systems dictated by company policies and procedures.
  • Ensure accounts are processed in accordance to Eligibility Program standards, Client expectations, and all applicable federal and state regulations guidelines.
  • Responsible for understanding and complying with all policies, procedures, and regulations relating to job duties.
    Perform other duties as assigned by management.


  • High School Diploma or General Educational Development (GED) certificate or equivalent in relevant work experience desired.
  • Previous healthcare coverage/eligibility experience preferred.
  • Proficient personal computer skills including Microsoft Office.
  • Ability to maintain the highest level of confidentiality.
  • Bilingual (Spanish) a plus.
  • Excellent interpersonal, written, and oral communication skills.
  • Ability to work in a team fostered environment.
  • Ability to work in a multi-tasked environment.
  • Ability to prioritize and organize work.
  • Ability to adapt to a flexible schedule.
Work Environment
  • Office environment.
  • Ability to lift and/or move 20 pounds with or without accommodation.
We provide Equal Employment Opportunity for all individuals regardless of race, color, religion, gender, age, national origin, marital status, sexual orientation, gender identity, status as a protected veteran, genetic information, status as a qualified individual with a disability and any other basis protected by federal, state or local laws.
 
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