Eligibility Specialist (Contract)

The role

The Eligibility Specialist will verify patient insurance coverage and eligibility for services. This role supports the Revenue Cycle team by maintaining billing processes and ensuring patients understand their financial responsibility.

What you will do

• Verify patient insurance coverage, benefits, and eligibility using AthenaHealth and payer portals.
• Obtain and track pre-authorizations for services when required by the payer.
• Identify primary and secondary insurance coverage to ensure proper coordination of benefits.
• Maintain accurate documentation of insurance verification outcomes in the system.
• Collaborate with billing specialists and patients to resolve eligibility issues, claim holds, or denials.
• Maintain proprietary insurance-provider mapping database in collaboration with Operations team.
• Notify patients of discrepancies in coverage or issues with insurance eligibility.
• Ensure patient insurance information is correctly recorded for accurate billing and reimbursement.
• Conduct follow-up on pending insurance verifications.
• Use AthenaHealth, payer portals and other tools to confirm eligibility before appointments.

Required qualifications

• Minimum of 2 years of experience in medical billing, front office, insurance verification, or eligibility-related roles.
• Proficient with AthenaHealth or another EHR, insurance payer portals and other eligibility verification systems.
• Must have eligibility experience with major commercial plans, across multiple states in a telehealth model.
• Strong verbal and written communication skills.
• Proven ability to investigate, resolve, and prevent issues related to insurance verification and eligibility.
• High degree of accuracy in verifying patient data and maintaining records.
• Ability to thrive in a fast-paced, growing environment.

Before you apply

• This is a 1099 independent contractor opportunity.
• Midi is unable to provide visa sponsorship.
• All Candidates must be authorized to work in the United States without current or future sponsorship needs.

About the company

Midi Health is an Equal Opportunity Employer. Their patients love them.