Eligibility and Benefits Specialists are an integral part of our billing team. We offer training in real time with your team
lead; you will be mentored and coached through your responsibilities while you gain confidence and experience in a fast
paced, team oriented environment. Eligibility and Benefits Specialists are responsible for assisting patients with checking
the status of their insurance coverage, check which benefit to use, confirm if the provider can see a pt with this
insurance, and to advise the front desk employees which insurance to add.

Essential Functions

● Verify patient insurance coverage and benefits prior to services being rendered.
● Obtain and document detailed information regarding patient eligibility, including coverage limits, co-pays,
deductibles, and pre-authorization requirements.
● Ensure that verification is conducted accurately and efficiently to prevent claim denials or delays.
● Serve as a liaison between patients, insurance companies, and healthcare providers to facilitate the verification
process.
● Address and resolve any patient or provider inquiries related to insurance benefits and eligibility.
● Provide clear and concise information to patients regarding their insurance coverage and financial responsibilities.

Competencies

● Excellent communication skills, both verbal and written, with the ability to interact professionally and
compassionately with patients and colleagues.
● Strong organizational skills and attention to detail, with the ability to multitask and prioritize tasks effectively.
● Proficiency in computer skills, including data entry and experience with electronic medical records systems.
● Ability to maintain confidentiality and adhere to HIPAA regulations regarding patient privacy and information
security.
● Prior experience in a healthcare setting or customer service role is preferred/is a must, but not required. Training
will be provided for the right candidate.
● Native-like English proficiency in speaking, reading and writing.
● Native-like Spanish/Russian/or any other language as needed proficiency in speaking, reading and writing
● Demonstrate high levels of accuracy and thoroughness in verifying insurance benefits and eligibility.
● Ability to analyze information, identify problems, and develop solutions to resolve issues related to insurance
verification and eligibility