Insurance Eligibility & Verification Specialist

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🎸 Tennessee – Remote

🎸 Tennessee – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔒 Insurance

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Athena Care

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2001

🏥 Healthcare

👥 B2C

Healthcare • B2C

Athena Care is a Tennessee-based mental and behavioral health provider operating outpatient clinics and telehealth services across multiple cities (Nashville, Franklin, Murfreesboro, Hendersonville, Clarksville, Memphis, Knoxville). For over 20 years they have offered diagnostic assessments, medication management, psychotherapy, autism testing, intensive outpatient programs, and interventional psychiatry treatments such as Spravato (esketamine), ketamine therapy, and transcranial magnetic stimulation (TMS). Athena Care provides a range of therapy modalities (CBT, DBT, EMDR, ACT, psychodynamic, interpersonal, CBT-I), is in-network with most major insurers, and emphasizes improving access to quality mental health care in Tennessee.

📋 Description

• Collect, review, and validate patient insurance information for eligibility and benefits verification • Identify behavioral health carve-outs and determine the appropriate mental health payer • Review Coordination of Benefits information to determine primary and secondary payer responsibility • Document eligibility and benefit information in the electronic health record and designated systems • Use payer websites, provider portals, Availity, and telephone verification to obtain benefit information • Communicate eligibility findings, authorization requirements, and financial responsibility to internal departments • Identify discrepancies and proactively resolve insurance information issues • Maintain productivity and quality standards in a high-volume workload • Stay current on payer policy updates, insurance regulations, and behavioral health reimbursement requirements • Maintain patient confidentiality and comply with HIPAA regulations and organizational policies

🎯 Requirements

• Minimum of 4 years of insurance eligibility and benefits verification experience • Minimum of 2 years of behavioral health insurance verification experience • Extensive experience navigating payer portals and Availity • Strong understanding of insurance terminology, benefit structures, and behavioral health coverage • High level of accuracy and attention to detail • Excellent verbal and written communication skills • Strong organizational and time management abilities • Ability to navigate multiple software applications simultaneously • Strong analytical and problem-solving skills • Adaptability and flexibility in a changing work environment • Strong customer service and patient-centered mindset • Collaborative, professional, and team-oriented approach • Ability to work independently in a remote environment while maintaining productivity and accountability • Ability to maintain confidentiality and exercise sound judgment • Experience using eClinicalWorks (eCW) is a bonus, not required • Ability to work a standard full-time schedule of 40 hours per week • Dependable attendance and ability to consistently meet productivity and quality expectations • Requires prolonged computer use and frequent interaction with electronic systems and payer portals

🏖️ Benefits

• Health insurance • Dental insurance • Vision insurance • Life insurance • 401(k) with employer match