Insurance Enrollment & Verification Specialist

Care Alliance Health Center; Cleveland (OH); On-site; USD 38,000 - 60,000; Full time

Benefits offered by this job

Paid Time Off

10 paid holidays

Medical, dental, and vision insurance

Life insurance

Retirement plan with up to a 7% match

Job summary

Care Alliance Health Center in Cleveland seeks an Insurance Enrollment & Verification Specialist to assist patients with insurance verification, enrollment, and coverage maintenance. You will verify eligibility, help with renewals, and address coverage barriers to ensure timely access to care.

You will communicate clearly with patients, maintain accurate records in the EHR, and support uninsured or underinsured patients with Medicaid, Medicare, and Marketplace options.

Qualifications

• High school diploma or GED required.
• At least two years of experience in insurance verification, enrollment, or related roles.
• Knowledge of health insurance eligibility and payer requirements.
• Ability to explain insurance rules clearly to patients.
• Proficient with electronic health records and payer portals.
• Able to complete enrollment-assister certifications.

Responsibilities

• Verify patient insurance eligibility, benefits, and coverage prior to scheduled services.
• Identify and resolve insurance discrepancies and coverage issues.
• Contact patients regarding expiring or unverified insurance and provide next steps.
• Maintain accurate insurance and guarantor information in the EHR.
• Identify issues that could lead to claim denials or delayed reimbursement.
• Assist patients with Medicaid, Marketplace, and other eligibility processes.

Skills

Organized

Detail-oriented

Strong communication

Customer service mindset

Healthcare enrollment knowledge

Education

High school diploma or GED

Associate degree in Healthcare Administration

Job description

Description

Are you passionate about helping patients navigate healthcare coverage while ensuring they have access to the care they need? Care Alliance Health Center is seeking an Insurance Enrollment & Verification Specialist to support patients with insurance verification, enrollment, and coverage maintenance.

At Care Alliance, our mission is to transform lives by providing exceptional, accessible, and compassionate healthcare experiences for all. As an Insurance Enrollment & Verification Specialist, you will play an important role in helping patients access the care they need while creating a positive, respectful, and patient-centered experience.

What You'll Do

In this role, you will help patients understand and maintain their healthcare coverage, assist with Medicaid renewals and other enrollment needs, and identify coverage issues before they become barriers to care. You will also play an important role in ensuring accurate insurance information and helping prevent registration-related claim denials.

Key responsibilities include:

• Verify patient insurance eligibility, benefits, and coverage prior to scheduled services.
• Identify and resolve insurance discrepancies and coverage issues.
• Contact patients regarding expiring, inactive, terminated, or unverified insurance and provide clear next steps.
• Maintain accurate insurance, eligibility, and guarantor information within the electronic health record.
• Identify registration and eligibility issues that could result in claim denials, delayed reimbursement, or unnecessary patient balances.
• Identify patients approaching Medicaid renewal and proactively assist with redetermination requirements.
• Conduct outreach to patients regarding renewal deadlines and required documentation.
• Assist uninsured and underinsured patients with Medicaid, Medicare, Marketplace, and other eligible coverage applications and renewals.
• Identify patients at risk of losing coverage and help address barriers before coverage lapses.
• Review self-pay patients for potential insurance eligibility and connect them with appropriate coverage options.
• Refer uninsured patients for Sliding Fee Discount Program screening when appropriate.
• Help patients understand coverage requirements, renewal deadlines, documentation needs, and available insurance resources.
• Assist patients with navigating insurance and enrollment processes.
• Provide respectful, patient-centered support to individuals from diverse backgrounds and circumstances.
• Connect patients with appropriate enrollment resources and alternative coverage options when needed.

Why Join Care Alliance?

Care Alliance is committed to compassionate, high-quality, and accessible healthcare that empowers individuals and strengthens communities. When you join our team, you become part of a mission-driven organization focused on advocacy, access, excellence, and respect for every patient we serve.

We offer a competitive benefits package, including:

• Paid Time Off
• 10 paid holidays
• Medical, dental, and vision insurance
• Life insurance
• Retirement plan with up to a 7% employer match

Work Environment

This position works in a clinical setting with frequent interaction with patients, families, and care teams.

Requirements

What We're Looking For

The ideal candidate is organized, detail-oriented, comfortable navigating insurance systems, and enjoy helping people solve problems.

Required Qualifications

• High school diploma or GED required.
• At least two years of experience in insurance verification, patient access, Medicaid or Marketplace enrollment, revenue cycle, financial counseling, healthcare registration, or a related role.
• Working knowledge of health insurance eligibility, benefits, managed care, patient responsibility, and coordination of benefits.
• Ability to interpret insurance and payer information and explain requirements to patients in clear, understandable language.
• Strong attention to detail, organization, communication, and follow-through.
• Comfortable working with electronic health records, payer portals, web-based systems, and Microsoft Office applications.
• Ability to complete required enrollment-assister certifications and annual training.

Preferred Qualifications

• Associate degree in Healthcare Administration, Human Services, Business, Medical Billing, or a related field.
• Experience in an FQHC, safety-net healthcare organization, health plan, hospital, county eligibility office, or community enrollment program.
• Experience with Epic, preferably OCHIN Epic.
• Experience with Ohio Medicaid, Marketplace, and payer eligibility systems.
• Current Certified Application Counselor (CAC) or comparable enrollment-assister certification.
• Bilingual or multilingual skills that reflect the communities we serve.