Eligibility Specialist at Brightside Health

, , United States -

Full Time

Start Date

Immediate

Expiry Date

06 Feb, 26

Salary

24.0

Posted On

08 Nov, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Advanced Excel Skills, Insurance Eligibility Verification, Strong Work Ethic, Resourcefulness, Attention to Detail, Oral Communication Skills, Written Communication Skills, Organizational Skills, Time Management Skills, Data Entry, HIPAA Compliance, Problem Solving, Proactive Approach, Member Interaction, Financial Reconciliation, Insurance Knowledge

Industry

Mental Health Care

Description

We are looking for an experienced Eligibility Specialist to help us successfully launch, manage, and scale our insurance offering in the market. You will be responsible for resolving member eligibility inquiries and working across multiple departments. We're looking for a self-starter who can work productively under tight deadlines without compromising attention to detail. This individual should be very comfortable working in Excel and have a natural drive for putting order to unstructured information processes. What you’ll be doing as Eligibility Specialist: Advanced Excel skills, with the demonstrated ability to write formulas, perform VLOOKUP, pivot tables, etc. Accurately calculate figures and reconcile accounts using financial information from members. Knowledgeable of EDI 270/271 transactions and insurance eligibility verification. Strong work ethic, resourcefulness, and the motivation to succeed. Connect with members directly through phone and email tickets to address insurance and eligibility questions. Comfort handling sensitive health, financial, and demographic information with discretion and professionalism. Take a proactive approach to identify and resolve issues. Experience working with insurance companies in the healthcare provider industry. Excellent organizational and time management skills, with sharp attention to detail. Take initiative and thrive in a semi-structured and dynamic work environment. Strong oral and written communication skills. Commitment to representing Brightside with integrity and professionalism in all interactions. Passion for helping patients access mental health care. Requirements: Support day-to-day verification of accurate member eligibility and insurance coverage across multiple payer plans and systems. Resolve eligibility inquiries and create a process to support cross-function information sharing around outcomes. Review, update and maintain accurate eligibility data in our information systems. Perform extensive data entry. Work with billing and engineering teams to continuously improve upon current eligibility verification processes, adapting processes to frequent changes in technology and/or payer requirements. Maintain knowledge of industry standards for insurance verification. Understand and adhere to HIPAA policies, procedures, and regulations, maintaining strict confidentiality. Participate in special projects and provide ad hoc analytical eligibility support. 3-5 years previous experience in medical billing, current A/R & experience in patient services a plus. Meet quality and performance standards for all eligibility projects. Benefits: A competitive hourly rate between $18 to $24 Comprehensive health care (medical, dental, vision) Pet Insurance Life Insurance & Short / Long Term Disability 401k Plan 15 Days PTO Parental Leave Work remotely Additional memberships and perks Final offer amounts are determined by multiple factors, including geographic location as well as candidate experience and expertise. If you have questions on compensation bands, please ask your recruiter. Brightside Health is committed to equal employment opportunities for all team members. Every decision we make regarding employment is solely based on merit, competence, and performance. We are committed to building a team that represents a variety of backgrounds, perspectives, and skills. We realize the full promise of diversity and want you to bring your whole self to work every single day. Research shows that minority groups typically apply only if they meet 100% of the criteria listed. At Brightside, we are dedicated to fair play and encourage women, people of color, and LGBTQ+ job seekers to apply for positions even if they don’t check every box for the role.

Responsibilities

As an Eligibility Specialist, you will resolve member eligibility inquiries and work across multiple departments to support the insurance offering. You will also maintain accurate eligibility data and improve verification processes.