Eligibility Specialist (Contract)
Core
Verify patient insurance coverage, benefits, and eligibility to ensure billing compliance and smooth revenue cycle operations.
Role type
Contract eligibility specialist (medical billing)
Builds
Accurate insurance verification records and pre-authorizations for telehealth services
Domain
Healthcare / Medical Billing
Required skills
AthenaHealth, payer portals, eligibility verification, commercial plan knowledge, multi-state experience, data accuracy, issue resolution
Preferred skills
Zendesk, EHR systems, patient communication, coordination of benefits
Responsibilities
Verify patient insurance coverage and benefits using AthenaHealth and payer portals; Obtain and track pre-authorizations for services; Identify primary and secondary insurance for coordination of benefits; Maintain accurate documentation of verification outcomes; Collaborate with billing specialists and patients to resolve eligibility issues; Notify patients of coverage discrepancies; Ensure correct recording of patient insurance information; Conduct follow-up on pending verifications.
Seniority
Mid-level, hands-on IC