Eligibility and Benefits Specialist

Job not on LinkedIn

🔥 0 minutes ago

🌵 Arizona, Florida, +10 more states – Remote

🌵 Arizona – Remote 🐊 Florida – Remote 🥔 Idaho – Remote ⚜️ Louisiana – Remote 🗻 New Hampshire – Remote 🌲 North Carolina – Remote 🏰 Missouri – Remote 🌴 South Carolina – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote

💵 $47k - $52k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👩‍👩‍👧‍👦 Human Resources (HR)

👻 Ghost score 0%

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Connecting for Better Health

WebsiteLinkedInAll Job Openings

1 - 10 employees

Founded 2021

🏥 Healthcare

💼 Consulting

⚖️ Legal

Healthcare • Consulting • Legal

Connecting for Better Health is a nonprofit coalition dedicated to improving health and social service data sharing in California. The organization brings together providers, caregivers, health plans, advocates, and community organizations to collaborate on enhancing data sharing policies. Their initiative promotes the Data Exchange Framework (DxF), which aims to facilitate secure and efficient exchanges of health and social services information to support better whole-person care.

📋 Description

• Verify patient insurance eligibility, benefits, authorization requirements, and referral needs before services • Obtain referrals from primary care providers and referring physicians • Track referral status and follow up with provider offices, payers, and patients • Document insurance coverage, benefit information, referrals, and eligibility details in internal systems • Communicate coverage, patient financial responsibility, estimated out-of-pocket costs, and billing model • Research and resolve eligibility, coverage, referral, and insurance discrepancies • Monitor verification queues, insurance changes, pending requests, and coverage updates • Resolve claim rejections related to eligibility, benefits, coverage, or referrals • Communicate with patients, providers, payers, and internal stakeholders • Collaborate with Billing, Accounts Receivable, Clinical Operations, and cross-functional teams • Analyze verification data to identify trends, root causes, and process improvements • Monitor and report eligibility, referral, and verification metrics • Improve workflows, operational efficiency, claim denial rates, and patient financial experience • Ensure compliance with organizational policies, payer requirements, HIPAA, and healthcare billing regulations

🎯 Requirements

• Bachelor's Degree in Business Administration or relevant course work • 2+ years of healthcare revenue cycle experience focused on eligibility, benefits, insurance verification, or patient access • Experience verifying insurance eligibility, benefits, authorizations, and obtaining referrals across multiple commercial and government payers • Hands-on experience using payer portals, Availity, and other insurance verification tools, including phone verification • Experience working successfully in a remote work environment and managing priorities independently • Proficiency with EMR and insurance verification systems • Strong customer service, communication, and interpersonal skills • Strong organizational, analytical, and problem-solving skills with exceptional attention to detail • Proficiency with Google Workspace (Sheets, Docs, Gmail) and ability to quickly learn new systems and technology

🏖️ Benefits

• Bonus eligibility • Employer-sponsored medical, dental, and vision coverage • Flexible Time off • 11 paid company holidays • Eligibility to contribute to 401(k) • Remote-first — work from home within approved states • Tailored professional development opportunities • Access to Overalls life concierge service