Eligibility Specialist
A company is looking for an Eligibility Specialist to improve mental healthcare access by managing eligibility processes. Key Responsibilities Verify patient eligibility and benefits using clearinghouses and payer portals to ensure accurate claims submission Investigate and resolve eligibility-related denials by researching coverage details and correcting discrepancies Draft appeals for claim denials and ensure patient data is accurate and up to date Required Qualifications At least 2 years of experience in Medical Billing or a healthcare setting Strong understanding of healthcare claims, plan benefits, and patient responsibilities Experience with CMS 1500 forms and knowledge of data, coding, and policy errors Highly organized and process-driven with the ability to prioritize workflows Ability to adapt to a fast-paced environment with changing priorities
A company is looking for an Eligibility Specialist to improve mental healthcare access by managing eligibility processes.
Key Responsibilities
Verify patient eligibility and benefits using clearinghouses and payer portals to ensure accurate claims submission
Investigate and resolve eligibility-related denials by researching coverage details and correcting discrepancies
Draft appeals for claim denials and ensure patient data is accurate and up to date
Required Qualifications
At least 2 years of experience in Medical Billing or a healthcare setting
Strong understanding of healthcare claims, plan benefits, and patient responsibilities
Experience with CMS 1500 forms and knowledge of data, coding, and policy errors
Highly organized and process-driven with the ability to prioritize workflows
Ability to adapt to a fast-paced environment with changing priorities
