Eligibility Specialist

A company is looking for an Eligibility Specialist to manage and scale their insurance offerings while resolving member eligibility inquiries.

Key Responsibilities

Verify member eligibility and insurance coverage across multiple payer plans and systems

Resolve eligibility inquiries and maintain accurate eligibility data in information systems

Collaborate with billing and engineering teams to improve eligibility verification processes

Required Qualifications

3-5 years of experience in medical billing or patient services

Proficiency in advanced Excel functions, including formulas and pivot tables

Knowledge of EDI 270 / 271 transactions and insurance eligibility verification

Understanding of HIPAA policies and maintaining confidentiality

Strong organizational and time management skills