Eligibility Specialist

Job Summary

A company is looking for an Eligibility Specialist to enhance pre-service operations and ensure client coverage verification.

Key Responsibilities

• Verify patient eligibility and benefits using clearinghouses and payer portals
• Investigate and resolve eligibility-related denials and resubmit claims as necessary
• Maintain accurate patient data and prioritize workflows based on claim age

Required Qualifications

• At least 2 years of experience in Medical Billing or a healthcare setting
• Strong understanding of healthcare claims and plan benefits
• Experience with CMS 1500 forms and knowledge of data, coding, and policy errors
• Highly organized and process-driven
• Ability to adapt to a fast-paced environment with changing priorities