Medical Billing & Eligibility Quality Specialist

Reliable Respiratory; South Windsor (CT); On-site; USD 55,000 - 75,000; Full time

Job summary

Reliable Respiratory seeks a Quality Specialist to review patient charts and orders, ensuring complete information and proper authorization for claims. The role supports payors, providers and families with timely data and accurate documentation.

Responsibilities include updating insurance policies, verifying eligibility, and handling basic billing tasks while maintaining high standards of customer service and compliance in a fast-paced, office-based setting in Connecticut.

Qualifications

• 18 years of age or older
• Must be eligible to work in the United States and not require work authorization from us now or in the future
• Associate’s degree required or 2 years of relevant (authorization, claims, quality or billing) experience
• Experience with insurance eligibility and billing processes is preferred

Responsibilities

• Ensure patient charts are accurate and complete.
• Ensure sales orders are accurate and complete.
• Update patient insurance policies and adjust sales orders as needed.
• Obtain current patient information and medical documentation for timely processing of sales orders.
• Verify patients’ insurance eligibility and benefits with payors.
• Perform basic billing functions to ensure correct billing dates.
• Explain payor requirements and appeals processes to providers and patients.
• Escalate accounts not meeting guidelines and stay updated on insurance rules.

Skills

Problem solving

Active listening

Decisiveness

Customer service

Attention to detail

MS Office

Independent work

Team collaboration

Regulatory compliance

Ethics

Education

Associate’s degree

2 years relevant experience

Tools

Microsoft Office Suite

Job description

Reliable Respiratory seeks a Quality Specialist to review patient charts and orders, ensuring complete information and proper authorization for claims. The role supports payors, providers and families with timely data and accurate documentation.

Responsibilities include updating insurance policies, verifying eligibility, and handling basic billing tasks while maintaining high standards of customer service and compliance in a fast-paced, office-based setting in Connecticut.