Eligibility Coordinator, Clinical Delivery

🔥 3 minutes ago

🇺🇸 United States – Remote

💵 $45k - $55k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

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Twin Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2018

⚕️ Healthcare Insurance

🤖 Artificial Intelligence

🧘 Wellness

Healthcare Insurance • Artificial Intelligence • Wellness

Twin Health is a company that focuses on improving the metabolic health of employees and health plan members by preventing and reversing chronic metabolic diseases. Utilizing proprietary Digital Twin AI technology, combined with smart devices, wearables, and a clinical care team, Twin Health provides personalized health recommendations. The solutions help in weight loss, lowering blood sugar levels, improving energy, mood, and sleep, and reducing dependency on costly medications by addressing the root causes of metabolic dysfunction. Their evidence-based programs deliver substantial health benefits, including considerable reduction in blood sugar levels, medication elimination, and overall metabolic health improvement, within six months.

📋 Description

• Perform routine and ad hoc insurance verification activities across a variety of commercial and employer-sponsored health plans. • Verify member eligibility, benefits, coverage requirements and coordination of benefits information, communicating through multiple channels (Zendesk, Salesforce, chat) • Review payer requirements and ensure authorizations are obtained prior to member participation in Twin programs. • Investigate and resolve eligibility discrepancies through collaboration with internal teams. • Maintain accurate documentation of eligibility determinations, verification activities, and member communications across multiple systems. • Support ongoing audits and quality assurance initiatives to ensure compliance with established operational standards. • Conduct outbound and inbound outreach regarding insurance verification, eligibility status, enrollment requirements, and coverage-related inquiries. • Provide clear, professional, and empathetic communication to members regarding eligibility outcomes and next steps. • Address member concerns and escalate complex issues when appropriate to ensure timely resolution. • Support members throughout the enrollment process by removing barriers to activation and participation. • Maintain high standards of member satisfaction through responsive and accurate support. • Support member conversion initiatives by identifying and resolving eligibility-related barriers to enrollment. • Assist with grievance resolution and member retention efforts by coordinating with internal external stakeholders. • Monitor enrollment and eligibility workflows to identify trends, process gaps, and opportunities for operational improvement. • Participate in special projects designed to improve enrollment efficiency and member experience. • Maintain, and update standard operating procedures (SOPs) and workflows. • Ensure processes remain aligned with changing payer requirements, internal policies, and operational needs. • Identify opportunities for automation, workflow enhancement, and operational scalability. • Communicate readily with Member Experience, Member Enrollment, Product, Engineering to coordinate eligibility-related activities. • Serve as a resource for eligibility process questions and operational best practices. • Contribute feedback and recommendations to improve workflows, member satisfaction, and operational performance. • Participate in team meetings, training initiatives, and process improvement discussions. • Support reporting and data collection efforts as needed. • Support Zendesk ticketing process • Assist with operational projects and organizational initiatives. • Perform other duties as assigned.

🎯 Requirements

• 2–4 years of experience in healthcare operations, insurance verification, patient registration, benefits administration, customer support, or a related field; or an equivalent combination of education and experience. • Experience verifying insurance coverage, benefits, eligibility, and authorization requirements. • Strong customer service and member-facing communication skills. • Excellent verbal and written communication skills with the ability to explain complex eligibility and insurance information clearly. • Strong attention to detail and commitment to accuracy. • Ability to prioritize multiple tasks and meet deadlines in a fast-paced environment. • Strong organizational, documentation, and follow-through skills. • Proficiency with Microsoft Office/Google Suite • Ability to work independently while collaborating effectively across teams.

🏖️ Benefits

• A competitive compensation package in line with leading technology companies • As a remote friendly company we are committed to providing opportunities for all who join to further build relationships, increase cross-functional collaboration, and celebrate our accomplishments. • Opportunity for equity participation • Unlimited vacation with manager approval • 16 weeks of 100% paid parental leave for delivering parents; 8 weeks of 100% paid parental leave for non-delivering parents • 100% Employer sponsored healthcare, dental, and vision for you, and 80% coverage for your family; Health Savings Account and Flexible Spending Account options • 401k retirement savings plan