Eligibility & Verification Specialist

About This Role

Our talent team is representing a confidential healthcare organization seeking an Eligibility & Verification Specialist to join their remote team. This position offers the opportunity to work directly with clinical staff, ensuring patients have seamless access to care through expert insurance verification and benefits coordination.

This is a fully remote role based in India or the Philippines, operating during US Eastern Standard Time (9 AM to 6 PM EST).

Responsibilities

• Verify patient insurance eligibility, benefits, and coverage across multiple payer types
• Obtain, track, and follow up on prior authorizations to ensure timely approvals
• Communicate directly with insurance providers to resolve coverage and authorization issues
• Contact patients and family members to discuss insurance-related concerns and financial responsibility
• Review and explain self-pay options when insurance coverage is unavailable or insufficient
• Accurately document insurance and authorization information in electronic health record systems
• Maintain current knowledge of Medicare, Medicare Advantage, Medicaid, and commercial insurance plans
• Utilize EHR systems, insurance portals, and other relevant technology tools effectively
• Demonstrate professionalism and collaborate with team members to solve problems efficiently
• Ensure all care coordination respects patient dignity and complies with privacy regulations

What We're Looking For

• Proven experience navigating insurance portals and verifying benefits on behalf of healthcare providers
• Familiarity with Athena EHR system or similar electronic health record platforms
• Background in medical billing processes and understanding of claims workflows
• Knowledge of in-network and out-of-network benefits verification
• Strong documentation skills and ability to understand medical terminology
• Excellent English communication skills (both written and verbal) for patient and insurance interactions
• Proficiency in Microsoft Office Suite
• Comfortable communicating with patients and families by phone regarding sensitive financial matters
• Professional demeanor and commitment to patient confidentiality and HIPAA compliance

Technical Requirements: You must have a reliable computer, noise-cancelling headset, second monitor, stable primary internet connection, and backup internet connection to ensure uninterrupted work.

How We Work With You

When you apply through Get A Job.ai, our recruiting team will review your qualifications and conduct an initial screening. If your background aligns with our client's needs, we will submit your profile to them for consideration. Please do not contact the client directly—all communication should flow through our team to ensure a smooth and professional process.

Pay

Compensation will be determined based on industry standards applicable to your location, work experience, and level of expertise.

Equal Opportunity: Get A Job.ai is committed to inclusive hiring practices and welcomes applications from qualified candidates of all backgrounds.