Eligibility and Benefits Specialist

Job Summary

To ensure patients have access to necessary care, the full-time remote Eligibility and Benefits Specialist will verify insurance benefits and eligibility prior to admission, reviewing patient policies and coordinating with insurance companies to prevent claim issues.

Key responsibilities

• Verify patient insurance coverage and eligibility for admission services with primary and secondary payors
• Access multiple insurance verification portals and Medicare files to confirm benefits and calculate coverage details
• Communicate benefit details and potential patient responsibilities to relevant team members to support a smooth admission process

Required qualifications

• High School Diploma or GED required; Associate's or Bachelor's Degree preferred in a healthcare-related field
• Certified Benefits Specialist certification preferred, or 2+ years of relevant experience in lieu of certification
• Experience in a healthcare-related area strongly preferred, with knowledge of medical terminology and revenue cycle management
• Detail-oriented with strong organizational skills and a commitment to operational excellence
• Fluency in English, both written and spoken