[Hiring] Eligibility and Verification Specialist @Limitlessli

Role Description

We seek a dedicated Eligibility and Benefits Specialist to join our remote team. In this role, you will work closely with clinical staff to verify insurance coverage, eligibility, and benefits. Your expertise in both 'in-network' and 'out-of-network' benefits, attention to detail, and ability to streamline processes will help ensure patients have access to the care they need. If you have a strong background in benefits verification and medical billing and a commitment to providing excellent service, we'd love to hear from you!

This position is remote and offers you the flexibility of working from home.

Essential Functions:

• Verify patient insurance eligibility, benefits, and coverage.
• Obtain, track, and follow up on prior authorizations.
• Communicate 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 the appropriate systems.
• Maintain a working knowledge of Medicare, Medicare Advantage, Medicaid, and commercial insurance plans.
• Utilize EHR systems, insurance portals, and other relevant technology tools effectively.

Expectations:

• Demonstrates and maintains a positive, professional manner.
• Manages time efficiently and effectively.
• Provides leadership as a role model to promote a team approach.
• Collaborates and participates in policy creation and appropriate problem-solving methods.
• Must adhere to all policies, procedures, terms and conditions set forth in the National Church Residences' Employee Information Guide (EIG) and the Code of Conduct.
• Ensures all care is provided with respect and dignity for the residents/clients, their families, and the staff.
• Reports all complaints made by residents/clients and/or families to the appropriate supervisors.
• Reports all allegations of abuse, misappropriation of funds/resident property, and/or any other corporate compliance issues.
• Completes all annual education requirements timely, including but not limited to Compliance, Privacy, Security, and HIPAA training.
• Exhibits behavior as set forth by the Code of Conduct in the performance of their duties.
• Performs other duties as assigned.

Qualifications

• Have experience navigating insurance portals.
• Be familiar with the Athena EHR system.
• Be comfortable communicating with patients and families by phone.
• Must have a background in benefits and eligibility verification for claims on behalf of the provider.
• Knowledge of medical billing processes.
• Strong documentation skills and ability to understand medical jargon.
• Excellent English writing and communication skills.
• Proficiency in Microsoft Office Suite.

Requirements

• You will need to have some essential tools: a reliable computer and noise-cancelling headset, a second monitor for enhanced productivity, and a stable internet connection.
• You'll also be required to have a backup internet connection, ensuring that you're well-equipped to complete your work seamlessly.

Benefits

• Embrace the flexibility and convenience of a remote working environment.
• Collaborate with an international team while contributing to our growing business.
• Work from the comfort of your home.

Company Description

At Limitlessli, we specialize in recruiting, hiring, and managing high-caliber remote staff for dynamic and growing healthcare facilities. Leveraging our extensive global network, we connect clients with highly qualified professionals, offering tailored services to meet our clients' unique business needs.