Eligibility Specialist

Responsibilities

• Verify patient insurance coverage, benefits, and eligibility using AthenaHealth and payer portals
• Obtain and track pre-authorizations for services
• Identify primary and secondary insurance coverage to ensure proper coordination of benefits
• Maintain accurate documentation of insurance verification outcomes for billing compliance
• Collaborate with billing specialists and patients to resolve eligibility issues or claim denials
• Maintain proprietary insurance-provider mapping database in collaboration with Operations
• Notify patients of coverage discrepancies and provide clear guidance
• Ensure patient insurance information is correctly recorded for accurate reimbursement
• Conduct follow-up on pending insurance verifications to prevent service delays

Requirements

• Minimum of 2 years of experience in medical billing, front office, or insurance verification
• Proficiency with AthenaHealth or another EHR and insurance payer portals
• Experience with major commercial plans across multiple states in a telehealth model
• Strong verbal and written communication skills
• Proven ability to investigate and resolve insurance verification issues
• High degree of accuracy in data verification and record maintenance

About the Company

Midi Health provides specialized care for patients, focusing on delivering high-quality clinical services through a telehealth model.