[Hiring] Eligibility and Verification Specialist @Flexscale

Role Description

We are looking for a detail-oriented Eligibility and Verification Specialist to join our growing team. In this role, you will be responsible for verifying patient insurance eligibility, ensuring accurate payer information, and supporting clean claim submissions to minimize billing delays and denials.

• Perform insurance eligibility verification for all scheduled patients prior to service
• Review patient insurance cards and accurately extract:
  • Member ID
  • Group number
  • Payer details
  • Plan type and coverage specifics
• Verify benefits through:
  • Insurance portals
  • Clearinghouses
  • Direct payer websites
  • Phone calls to insurance companies or patients when needed
• Identify and document:
  • Active/inactive coverage
  • Deductibles, co-pays, and co-insurance
  • Referral or authorization requirements
• Ensure correct payer ID selection for claim submission
• Flag discrepancies and communicate proactively with front desk or billing teams
• Investigate and resolve eligibility-related claim rejections and issues
• Re-verify eligibility for high-risk or previously denied claims
• Maintain accurate and detailed documentation in billing/EMR systems
• Stay current on payer-specific rules, policies, and updates

Qualifications

• 2+ years of experience in U.S. medical billing and insurance verification
• Strong knowledge of:
  • Commercial insurance, Medicare, and Medicaid
  • Payer portals and eligibility tools
  • Claim workflows and clearinghouses
  • Authorization and referral workflows
• Ability to interpret insurance cards and determine correct payer routing
• Experience handling eligibility-related issues and claim rejections
• Comfortable making outbound calls to U.S. insurance companies and patients
• Strong attention to detail and organizational skills
• Excellent communication and documentation abilities
• Experience with EMR/EHR and billing systems preferred

Hiring Process

• Initial screening call with Flexscale: A brief conversation to walk through your background, experience, and role alignment.
• Interview with the client: Meet key stakeholders to discuss your experience, skills, and how you approach the role.
• Final interview with the client: A deeper conversation focused on long-term fit, expectations, and next steps.