Eligibility Specialist

Job Summary

To support the insurance revenue cycle for behavioral health services, the full-time remote Eligibility Specialist will verify insurance eligibility and benefits for new and existing patients, ensuring compliance with payer requirements and initiating necessary authorization workflows.

Key responsibilities

• Complete insurance eligibility and benefit verification using various systems and resources
• Identify and address insurance-related barriers and ensure required authorizations are obtained prior to services
• Collaborate with Intake, Clinical Operations, and Authorization teams to resolve discrepancies and streamline processes

Required qualifications

• Strong understanding of health insurance eligibility, benefits, and coverage limitations
• Minimum of one year of experience in insurance, eligibility verification, or medical billing preferred
• High school diploma or equivalent required; Associate's or Bachelor's degree in a related field preferred
• Ability to navigate various technology platforms and adapt to automated workflows
• Excellent organizational skills and ability to prioritize multiple time-sensitive requests