Insurance and Eligibility Specialist

Role Overview

A Revenue Cycle Management Insurance and Eligibility Specialist involves several critical tasks that help ensure that healthcare providers are reimbursed for their services while also providing a positive experience for patients.

Responsibilities

• Insurance Verification: Verify patient insurance information before appointments or procedures. Contact insurance companies to confirm coverage details and eligibility.
• Eligibility Assessment: Determine patient eligibility for services based on their insurance plans. Ensure pre‑authorizations are obtained for specific treatments or procedures.
• Data Management: Accurately input and update patient insurance information in the electronic health record (EHR) and billing systems. Maintain detailed records of verification processes and outcomes.
• Patient Communication: Inform providers about patient insurance benefits, potential out‑of‑pocket ...