Chronic Care Staffing is seeking a detail-oriented Patient Eligibility Assistant to join our team remotely. In this vital administrative role, you will ensure patients meet all medical and administrative requirements for participation in programs governed by CMS guidelines.
What You'll Do
- Review patient data to verify eligibility for programs like Chronic Care Management (CCM) and Remote Patient Monitoring (RPM).
- Confirm that patients have two or more chronic conditions listed in the CMS Chronic Condition Data Warehouse (CCDW).
- Consult a supervisor for conditions not listed in CCDW.
- Verify patients have seen their Primary Care Provider (PCP) or a specialist within the past 12 months.
- Review EHR documentation to confirm eligibility requirements are met.
- Review and confirm patient insurance coverage details within the EHR.
- Compare patient insurance against practice-specific contracted insurers to confirm eligibility.
- Maintain meticulous and compliant documentation in adherence to HIPAA regulations.
- Communicate eligibility status and updates to internal teams.
What We're Looking For
- Proficiency with Electronic Health Record (EHR) systems, specifically eClinicalWorks and/or Athena.
- Experience with Medicare and commercial insurance verification.
- Strong attention to detail when reviewing medical or insurance documentation.
- Excellent communication, time management, and organizational skills.
- Familiarity with Google Suite and other company-approved software tools.
- Ability to maintain confidentiality and comply with HIPAA regulations.
Nice to Have
- Previous experience in healthcare administration, patient eligibility review, or insurance verification.
- Understanding of CMS eligibility requirements and chronic condition criteria.
Technical Stack
- Electronic Health Record (EHR) systems (e.g., eClinicalWorks, Athena)
- Google Suite
Team & Environment
You will collaborate closely with both clinical and administrative teams.
Benefits & Compensation
- $15–$16/hour
- Paid Time Off
- 401(k) Retirement
- Health Care, Dental, and Vision coverage
- No Weekend Work
- Growth Opportunities
Work Mode
This is a fully remote position.
Chronic Care Staffing is an equal opportunity employer.
