Expert care for women 40+. Made for midlife. Delivered by experienced clinicians. Covered by insurance.
Eligibility Specialist – Contract
Location
United States
Posted
1 day ago
Salary
$20 / hour
Seniority
Mid Level
Job Description
Eligibility Specialist – Contract
Midi Health
• Accurately verify patient insurance coverage, benefits, and eligibility using systems like AthenaHealth and payer portals. • Obtain and track pre-authorizations for services when required by the payer. • Identify primary and secondary insurance coverage to ensure proper coordination of benefits and avoid future claim denials. • Maintain accurate and up-to-date documentation of insurance verification outcomes in the system, ensuring billing compliance. • Collaborate with billing specialists and patients to resolve eligibility-related issues, claim holds, or denials. • In collaboration with Operations team, maintain proprietary insurance-provider mapping database to ensure billing compliance. • Notify patients of any discrepancies in coverage or issues with their insurance eligibility, providing patients with clear guidance and options. • Ensure patient insurance information is correctly recorded and maintained for accurate billing and reimbursement. • Conduct follow-up on pending insurance verifications to prevent delays in billing or service delivery. • Use AthenaHealth, payer portals and other tools efficiently to confirm patient eligibility and verify coverage before appointments.
Job Requirements
- Minimum of 2 years of experience in medical billing, front office, insurance verification, or eligibility-related roles.
- Proficient with AthenaHealth or another EHR, insurance payer portals and other eligibility verification systems.
- Must have eligibility experience with major commercial plans, across multiple states in a telehealth model
- Strong verbal and written communication skills, with the ability to explain complex insurance details to patients and internal team members.
- Proven ability to investigate, resolve, and prevent issues related to insurance verification and eligibility.
- High degree of accuracy in verifying patient data and maintaining records.
- Ability to thrive in a fast-paced, growing environment, while maintaining a focus on patient satisfaction and operational excellence.
Benefits
- This is a 1099 independent contractor opportunity and does not include company benefits
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