Insurance Eligibility & Authorization Specialist

Socket.dev; Niles (IL); On-site; USD 42,000 - 65,000; Full time

Benefits offered by this job

401(k)

401(k) matching

Dental insurance

Health insurance

Paid time off

Vision insurance

Job summary

Socket.dev is seeking an Intake and Eligibility Coordinator in Niles, IL to oversee insurance eligibility verification, authorization management, and disenrollment processes. This role interfaces with Case Managers, Billing, and branches to ensure seamless client care and accurate billing.

Ideal candidates have 3+ years in healthcare administration focusing on insurance verification and authorization, with experience in AxisCare, PSS, Availity, and EHR systems.

Qualifications

• High school diploma or equivalent required; associate's or bachelor's degree preferred.
• Minimum of 3 years of experience in a healthcare administrative role focusing on insurance verification, authorization, and eligibility.
• Experience with insurance portals (PSS, Availity, MCO portals) and EHR systems; AxisCare experience is a significant plus.

Responsibilities

• Verify insurance eligibility for new and existing clients daily across multiple portals; update master eligibility spreadsheet.
• Manage and renew authorizations; run monthly reports; consolidate requests for CCU and MCOs; track renewals and follow up with payers.
• Identify and manage disenrollment processes; verify new insurance; notify Billing and management to ensure continuity.
• Serve as hub for eligibility and authorization statuses; assist Billing and branches with authorization issues; maintain detailed documentation.
• Support Billing by resolving eligibility-related denials; assist Case Managers with redetermination reminders and service extension requests.

Education

Associate's degree or Bachelor's degree (related field)

High school diploma or equivalent

Tools

AxisCare

PSS

Availity

MCO portals

EHR systems

Job description

Socket.dev is seeking an Intake and Eligibility Coordinator in Niles, IL to oversee insurance eligibility verification, authorization management, and disenrollment processes. This role interfaces with Case Managers, Billing, and branches to ensure seamless client care and accurate billing.

Ideal candidates have 3+ years in healthcare administration focusing on insurance verification and authorization, with experience in AxisCare, PSS, Availity, and EHR systems.