Insurance and Eligibility Specialist

Verify patient insurance coverage and assess eligibility for benefits before appointments or procedures. Contact insurance companies to confirm details, obtain pre-authorizations for specific treatments, and ensure accurate information is processed for billing and claims submission. Accurately input and update patient data in electronic health records and billing systems while maintaining detailed records of verification processes. Inform providers about patient benefits, potential out-of-pocket costs, and required documentation, then collaborate with the billing department to resolve denied claims. Ensure all processes comply with healthcare regulations, including HIPAA and fair debt collection practices. Requires 2–3 years of billing experience and proficiency in EHR software.