Healthcare Eligibility Analyst II @Performant Recovery, Inc.

[Hiring] Healthcare Eligibility Analyst II @Performant Recovery, Inc.

Apr 14, 2025 - Performant Recovery, Inc. is hiring a remote Healthcare Eligibility Analyst II. 💸 Salary: hiring range: $54,200. 📍Location: USA.

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Role Description

The Healthcare Eligibility Analyst II plays an important role in the success of the Eligibility services we provide our clients by applying strong knowledge and skills to review and analyze large volumes of client records, investigate coverage to determine primacy, and initiate coverage updates that maximize revenue for our clients.

Leverage knowledge and expertise in COB/TPL/MSP to gather and review documentation and eligibility information.
Investigate the file to determine proper order of benefits when multiple forms of coverage are available, and resolve primacy issues.
Identify and solve non-standard and often complex data or record discrepancies and/or issues.
Communicate effectively with carriers to update validated eligibility records and primacy.
Contact Healthcare Insurance carriers, employers, and/or providers regarding eligibility discrepancies.
Educate Healthcare Insurance carriers, employers, and/or providers on the Coordination of Benefits Rules.
Analyze and understand written communication from insurance companies including explanation of benefits (EOBs).
Effectively work assigned inventories to consistently exceed productivity metrics assigned by management.
Research various scenarios that will bring to successful resolution and payment.
Update company systems with clear and accurate information.
Contribute to ideas and approaches to enhance products and services.
Assist representatives and junior analyst team members to answer questions and enhance knowledge/skills.
Follow and comply with company, departmental and client program policies, processes, and procedures.
Utilize resources to ensure compliance with client requirements, HIPAA, and applicable federal or state regulations.
Consistently achieve or exceed established metrics and goals assigned.
Perform other duties as assigned.

Qualifications

Strong knowledge and material on-point experience with healthcare, medical terminology, and medical coding.
Demonstrated expertise in Eligibility and related facets relevant to Commercial Third-Party Liability (TPL).
Proven strength in researching uncovered eligibility details and resolving data errors.
Demonstrates high degree of critical thinking and analytical accuracy.
Ability to communicate professionally and effectively with providers, carriers, beneficiaries, and other audiences.
Proven ability to gather and interpret Explanation of Benefits (EOB).
Protect patients’ privacy and adhere to HIPAA standards and regulations.
Remarkable interpersonal and communication skills.
Self-motivated and thrives in a fast-paced business operations department.
Strong skills using standard office technology and applications.
Intermediate to advanced Microsoft Excel skills.
Ability to follow policy, procedures, and regulations in the workplace.
Ability to effectively perform work independently and cooperatively with others.
Ability to adapt quickly and transition effectively to changing circumstances.

Requirements

High School diploma or GED required; some college preferred.
Minimum four years of directly relevant progressive experience.
Experience must demonstrate consistent ability to independently deliver high volume quality results.
Demonstrated experience gathering, researching, and documenting data and requirements for projects.

Benefits

Medical, dental, vision, and disability coverage options.
Life insurance coverage.
401(k) savings plans.
Paid family/parental leave.
11 paid holidays per year.
Sick time and vacation time off annually.

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📍	Be aware of the location restriction for this remote position: USA
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Healthcare Eligibility Analyst II @Performant Recovery, Inc.

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Salary 💸 hiring range: $54,200	Remote Location USA
Job Type full-time	Posted Apr 14, 2025

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📍	Be aware of the location restriction for this remote position: USA
‼	Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more.

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[Hiring] Healthcare Eligibility Analyst II @Performant Recovery, Inc.

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