Eligibility Specialist
New
M
Midi HealthMedical Billing
RemoteContractMiddle
Salary20 USD per hour
Apply NowOpens the employer's application page
Job Details
- Experience
- Minimum of 2 years of experience
- Required Skills
- ZendeskEHR
Requirements
- Minimum of 2 years of experience in medical billing, front office, insurance verification, or eligibility-related roles.
- Proficient with AthenaHealth or another EHR and insurance payer portals.
- Experience with major commercial insurance plans.
- Experience working in a telehealth model across multiple states.
- Strong verbal and written communication skills.
- Proven ability to investigate, resolve, and prevent issues related to insurance verification and eligibility.
- High degree of accuracy in verifying patient data and maintaining records.
- Ability to thrive in a fast-paced, growing environment.
Responsibilities
- Accurately verify patient insurance coverage, benefits, and eligibility using systems like AthenaHealth and payer portals.
- Obtain and track pre-authorizations for services when required by the payer.
- Identify primary and secondary insurance coverage to ensure proper coordination of benefits and avoid future claim denials.
- Maintain accurate and up-to-date documentation of insurance verification outcomes in the system, ensuring billing compliance.
- Collaborate with billing specialists and patients to resolve eligibility-related issues, claim holds, or denials.
- Maintain proprietary insurance-provider mapping database in collaboration with the Operations team.
- Notify patients of any discrepancies in coverage or issues with their insurance eligibility.
- Ensure patient insurance information is correctly recorded and maintained for accurate billing and reimbursement.
- Conduct follow-up on pending insurance verifications to prevent delays in billing or service delivery.
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