Eligibility & Verification Specialist

Visa Hunt; India; On-site; INR 5,258,000 - 7,170,000; Full time

Job summary

Limitlessli is seeking an Eligibility and Benefits Specialist to verify insurance coverage and benefits for patients in a fully remote role. You will work with clinical staff to confirm coverage and streamline processes from home.

The position requires experience with in-network and out-of-network benefits, prior authorizations, and accurate documentation in EHR systems. Strong English communication and medical billing knowledge are essential.

Qualifications

• Experience navigating insurance portals.
• Familiar with the Athena EHR system.
• Comfortable communicating with patients and families by phone.
• Background in benefits and eligibility verification for claims.
• 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.

Responsibilities

• 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.

Skills

Insurance portals

Phone communication

Benefits verification

Medical billing

Documentation

English communication

MS Office

Tools

Athena EHR

Job 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.

The Opportunity:

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), the Code of Conduct, as well as any facility handbook, including but not limited to, corporate
  compliance, drug free workplace, safe work practices, all federal, state, local regulations and laws.
• With respect to Resident Rights, 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, drug free workplace,
  safe work practices, all federal, state and local regulations and laws.
• Completes all annual education requirements timely, including but not limited to Compliance, Privacy, Security and HIPAA
  training and 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

Service Fee:

Industry standards applicable to the state depending on work experience and level of expertise.

Hours:

US Eastern Standard Time (EST) – 9 am to 6 pm

Why Limitlessli?

We embrace the flexibility and convenience of a remote working environment, and you will collaborate with an international team while contributing to our growing business, all from the comfort of your home.

Essential 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.

JOIN OUR TEAM!!

Originally posted on Himalayas