Eligibility Specialist

Midi Health; United States; Remote; USD 25,000 - 39,000; Full time

Job summary

Midi Health is seeking an Insurance Verification Specialist to support its telehealth operations. You will verify patient insurance coverage, manage eligibility checks, and coordinate pre-authorizations to ensure timely access to care.

Ideal candidates have experience with AthenaHealth or similar EHRs, and can navigate payer portals across multiple states. The role requires strong communication, accuracy, and collaboration with billing teams.

Qualifications

• 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.

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

Skills

Verbal communication

Written communication

Attention to detail

Tools

AthenaHealth

Payer portals

Job description

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.