Eligibility and Benefits Specialist

Responsibilities

• Verify patient insurance eligibility, benefits, authorization requirements, and referral needs
• Obtain and track referrals from primary care providers and referring physicians
• Document insurance coverage and eligibility details within internal systems
• Communicate insurance coverage and patient financial responsibility to patients
• Research and resolve eligibility, coverage, and insurance discrepancies
• Identify and resolve claim rejections related to eligibility or referral issues
• Collaborate with Billing, Accounts Receivable, and Clinical Operations teams
• Analyze verification data to identify trends and process improvement opportunities
• Ensure compliance with HIPAA and healthcare billing regulations

Requirements

• Bachelor's Degree in Business Administration or relevant coursework
• 2+ years of healthcare revenue cycle experience
• Experience with insurance verification, benefits, and obtaining referrals
• Hands-on experience with payer portals, Availity, and insurance verification tools
• Proficiency with EMR and insurance verification systems
• Proficiency with Google Workspace
• Ability to work successfully in a remote environment

Preferred Qualifications

• Experience in a startup or high-growth healthcare organization
• Experience in telehealth or virtual care
• Familiarity with revenue cycle workflows (billing, claims, AR)
• Experience with Athenahealth, Apero, or Salesforce
• Certified Revenue Cycle Representative (CRCR) certification

Benefits

• Salary range of $47,000-$52,000 per year plus bonus eligibility
• Employer-sponsored medical, dental, and vision coverage
• Unlimited PTO and 11 paid company holidays
• 401(k) contribution eligibility
• Access to Overalls life concierge services

About the Company

Oshi Health is a virtual digestive health practice on a mission to transform GI care. We combine compassionate, multidisciplinary care with innovative technology to help people with chronic digestive conditions get the answers and relief they deserve.