Remote Eligibility & Benefits Verification Specialist

CredSpun LLC; United States; Remote; USD 25,000 - 39,000; Full time

Job summary

CredSpun LLC is seeking a remote Insurance Eligibility & Benefits Verification Specialist to confirm patients’ coverage before visits. You will verify plans, benefits, and eligibility so the front desk collects the right information and claims don’t get denied later.

You will work with payer portals, Availity and real-time eligibility tools (270/271), determine if prior authorizations are needed, flag COB issues, and update patient demographics in the practice management system.

Qualifications

• 1+ year of insurance verification or front-end billing experience.
• Familiarity with payer portals, Availity and real-time eligibility (270/271).
• Understanding of HMO, PPO, EPO, Medicare Advantage and Medicaid plans.
• Ability to work quickly and accurately due to long schedules.

Responsibilities

• Verify active coverage for scheduled patients before their appointments.
• Confirm benefits for service type (copay, coinsurance, deductible).
• Determine if prior authorization or referral is needed and route accordingly.
• Identify COB issues and the correct primary payer.
• Update demographics and insurance details in the practice management system.
• Flag out-of-network or inactive coverage before visits.
• Note behavioral health carve-outs and plan-specific mental health benefits.

Skills

Insurance verification

Front-end billing experience

Payer portals proficiency

Attention to detail

Tools

Availity

270/271 eligibility tools

Job description

CredSpun LLC is seeking a remote Insurance Eligibility & Benefits Verification Specialist to confirm patients’ coverage before visits. You will verify plans, benefits, and eligibility so the front desk collects the right information and claims don’t get denied later.

You will work with payer portals, Availity and real-time eligibility tools (270/271), determine if prior authorizations are needed, flag COB issues, and update patient demographics in the practice management system.