Insurance Eligibility

Job Description:

• Verify patient insurance eligibility and benefits prior to scheduled services.
• Confirm active coverage, copays, deductibles, coinsurance, and patient responsibility estimates.
• Identify prior authorization requirements and escalate when needed.
• Track outstanding insurance claims (Accounts Receivable / AR).
• Contact insurance companies by phone, payer portals, or email to check claim status.
• Investigate denials, underpayments, rejections, and missing claim information.
• Correct claim issues and resubmit claims when necessary.
• Document all account activity and insurance updates accurately in the billing system.
• Escalate complex or long-pending claims to supervisors or billing leadership.
• Collaborate with scheduling, billing, and provider teams to prevent delays and claim denials.
• Maintain compliance with HIPAA, payer guidelines, and internal policies.
• Meet productivity, quality, and turnaround expectations in a high-volume environment.

Requirements:

• High school diploma or GED required.
• Bachelor’s degree preferred.
• 2+ years of experience in insurance follow-up, eligibility verification, medical billing, or healthcare revenue cycle operations preferred.
• Experience with AR follow-up, claims resolution, and payer portals required.
• Experience working with Medicare, Medicaid, and commercial insurance plans preferred.
• Strong understanding of insurance benefits, authorizations, and denial resolution.
• Prior remote work experience preferred.
• Strong verbal and written communication skills.
• Proficiency in Microsoft Office and healthcare systems.
• Experience with EHR systems and billing platforms preferred.
• Must be able to type a minimum of 35 words per minute (WPM) with no more than 3 errors.

Benefits:

• Comprehensive Health Coverage: Group medical, dental, and vision plans available from the first day of the month following 90 days of full-time employment.
• Life and Disability Insurance: Basic life/AD&D, short-term, and long-term disability coverage provided, with options for voluntary life/AD&D.
• 401(k) Retirement Savings Plan: Eligible to participate in the company’s 401(k) plan at the beginning of the first calendar quarter following 6 months of continuous service.
• Paid Time Off (PTO): Accrue Paid Time Off starting on your first day of employment.
• Flexibility in Benefits: The company reserves the right to amend, modify, or terminate any benefits programs as needed.