Medical Eligibility Specialist

Join our Team!

Medical Diagnostic Laboratories (MDL) is a CLIA certified clinical laboratory with multiple state licensing, specializing in state of the art, automated DNA based molecular analysis of a variety of chronic and infectious illnesses. MDL specializes and performs Polymerase Chain Reaction (PCR) with a larger menu of testing available in the field of infectious disease. Our main theme of research is in the field of Gynecology, Infectious Diseases, Infectious Arthritis, Tick-borne Diseases, Mycology, and Chronic Fatigue Syndrome (CFS).

MDL is looking to hire Medical Eligibility Specialists for their corporate office in Hamilton, NJ. On a day to day basis, this person will be responsible for verifying primary and secondary insurance coverage for patients. This individual will be in charge of contacting This individual will also be in charge of contacting physicians and healthcare providers to obtain necessary information to complete insurance verifications.

ESSENTIAL FUNCTIONS:
1. Calls insurance company to check patient eligibility to aid in billing process.
2. Conduct research over the phone or via the internet for eligibility purposes.
3. Obtain pre-authorizations when necessary.
4. Maintains and update knowledge of participating insurance carriers
5. Determine correct insurance mailing addresses for non electronic carriers.
6. Maintain the Medicaid pending file.
7. Maintain a daily insurance eligibility log.
8. Handle W-9 and medical records request.
9. Research and resolve insurance overpayment request (monthly)
10. Research and process forms for refund request.
11. Assist with fax cover sheets and billing holds as needed.
REQUIREMENTS
-Excellent organizational skills with strong attention to detail.
-Good oral and written communication skills.
-Ability to deal professionally, courteously, and effectively with the public.
-Knowledge of confidentiality requirements regarding patients.
-Knowledge of medical terminology.
-Data entry skills.
-High school graduate.
-Good analytical, organizational and problem solving skills