Eligibility Specialist – Contract

🕒 June 24

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Midi Health

WebsiteLinkedInAll Job Openings

51 - 200 employees

💼 Consulting

🛡️ Insurance

🍽️ Food & Beverage

Consulting • Insurance • Food & Beverage

Midi Health is the only virtual care platform dedicated to female midlife health, focusing specifically on perimenopause, menopause, and related health issues. Designed by experts, Midi Health aims to assist women aged 40 and above in navigating the complexities of midlife health through a holistic approach that considers individual health history, lifestyle, and genetics. The platform offers customized care plans that may include hormonal and non-hormonal medications, lifestyle coaching, wellness therapies, and more, all while being covered by most PPO insurance plans.

📋 Description

• Accurately verify patient insurance coverage, benefits, and eligibility using systems like AthenaHealth and payer portals. • Obtain and track pre-authorizations for services when required by the payer. • Identify primary and secondary insurance coverage to ensure proper coordination of benefits and avoid future claim denials. • Maintain accurate and up-to-date documentation of insurance verification outcomes in the system, ensuring billing compliance. • Collaborate with billing specialists and patients to resolve eligibility-related issues, claim holds, or denials. • In collaboration with Operations team, maintain proprietary insurance-provider mapping database to ensure billing compliance. • Notify patients of any discrepancies in coverage or issues with their insurance eligibility, providing patients with clear guidance and options. • Ensure patient insurance information is correctly recorded and maintained for accurate billing and reimbursement. • Conduct follow-up on pending insurance verifications to prevent delays in billing or service delivery. • Use AthenaHealth, payer portals and other tools efficiently to confirm patient eligibility and verify coverage before appointments.

🎯 Requirements

• Minimum of 2 years of experience in medical billing, front office, insurance verification, or eligibility-related roles. • Proficient with AthenaHealth or another EHR, insurance payer portals and other eligibility verification systems. • Must have eligibility experience with major commercial plans, across multiple states in a telehealth model • Strong verbal and written communication skills, with the ability to explain complex insurance details to patients and internal team members. • Proven ability to investigate, resolve, and prevent issues related to insurance verification and eligibility. • High degree of accuracy in verifying patient data and maintaining records. • Ability to thrive in a fast-paced, growing environment, while maintaining a focus on patient satisfaction and operational excellence.

🏖️ Benefits

• This is a 1099 independent contractor opportunity and does not include company benefits