Revenue Specialist
At DAP Health, we are committed to transforming lives and advancing health equity for all. As a leading nonprofit health care provider, we deliver compassionate, high-quality care to the diverse communities of the Coachella Valley and San Diego County. Our comprehensive services range from primary care to mental health, wellness programs, and beyond, with a focus on those who are most vulnerable. Joining our team means becoming part of a passionate, innovative organization dedicated to making a meaningful impact in the lives of those we serve. If you're looking for a dynamic and purpose-driven environment, we invite you to explore the opportunity to contribute to our mission.
Job Summary The Revenue Cycle Specialist is responsible for ensuring accurate and timely verification of patient insurance eligibility and benefits across all service locations. This role supports front-end revenue cycle operations by proactively verifying coverage, entering payer information into the electronic health record (EHR) and communicating eligibility details to front desk staff prior to patient visits. The Revenue Cycle Specialist serves as a key resource for patients by explaining insurance coverage, benefits, and financial responsibilities, and assists with identifying appropriate financial options when needed. Supervisory Responsibilities: None Essential Duties/Responsibilities
- Verify patient insurance eligibility and benefits for assigned locations at least two (2) days prior to scheduled appointments
- Perform real-time eligibility verification for walk-in patients and communicate status to front desk staff
- Enter and update payer and benefit information in the EHR
- Document expected patient financial responsibility for front desk collection
- Verify and validate that required referrals and/or prior authorization are in place for scheduled services based on payer requirements; escalate when missing; incomplete or invalid.
- Verify Medi-Cal, Medicare and commercial insurance.
- Answer incoming billing line calls and assist patients
- Educate patients on insurance coverage and benefits
- Assist with redirecting to CCS for financial options when coverage is limited
- Assist with claims processing- when applicable
- Complete assigned Epic work queues
- Maintain relationships with internal teams and payers
- Ensure compliance with policies and confidentiality
- Perform other duties as assigned