Insurance Eligibility (Remote)

About the position This role combines front-end insurance eligibility verification with back-end insurance follow-up responsibilities—helping reduce denials, improve reimbursement, and support a seamless patient financial experience from start to finish. The Insurance Eligibility & Follow-Up Specialist is responsible for verifying patient insurance coverage prior to service, tracking outstanding insurance claims, resolving denials, and ensuring timely reimbursement from insurance carriers. You’ll work closely with insurance companies, providers, patients, and internal teams to support both eligibility verification and accounts receivable follow-up functions. Strong knowledge of insurance plans, claims management, and revenue cycle processes is essential.

Responsibilities

• Follow-up with insurance companies on billed claims regarding claim status and resolution of payments in a timely manner.
• Verify patient insurance eligibility and benefits prior to scheduled services
• Confirm active coverage, copays, deductibles, coinsurance, and patient responsibility estimates
• Identify prior authorization requirements and escalate when needed
• Track outstanding insurance claims (Accounts Receivable / AR)
• Contact insurance companies by phone, payer portals, or email to check claim status
• Investigate denials, underpayments, rejections, and missing claim information
• Correct claim issues and resubmit claims when necessary
• Document all account activity and insurance updates accurately in the billing system
• Escalate complex or long-pending claims to supervisors or billing leadership
• Collaborate with scheduling, billing, and provider teams to prevent delays and claim denials
• Maintain compliance with HIPAA, payer guidelines, and internal policies
• Meet productivity, quality, and turnaround expectations in a high-volume environment
• Other duties as assigned

Requirements

• High school diploma or GED required
• Experience with AR follow-up, claims resolution, and payer portals required
• Strong verbal and written communication skills
• Proficiency in Microsoft Office and healthcare systems
• Must be able to type a minimum of 35 words per minute (WPM) with no more than 3 errors. A typing assessment will be administered during the interview process.

Nice-to-haves

• Bachelor’s degree preferred
• 2+ years of experience in insurance follow-up, eligibility verification, medical billing, or healthcare revenue cycle operations preferred
• Experience working with Medicare, Medicaid, and commercial insurance plans preferred
• Strong understanding of insurance benefits, authorizations, and denial resolution
• Prior remote work experience preferred
• Experience with EHR systems and billing platforms preferred

Benefits

• Comprehensive Health Coverage: Group medical, dental, and vision plans available from the first day of the month following 90 days of full-time employment.
• Life and Disability Insurance: Basic life/AD&D, short-term, and long-term disability coverage provided, with options for voluntary life/AD&D.
• 401(k) Retirement Savings Plan: Eligible to participate in the company’s 401(k) plan at the beginning of the first calendar quarter following 6 months of continuous service.
• Paid Time Off (PTO): Accrue Paid Time Off starting on your first day of employment.
• Flexibility in Benefits: The company reserves the right to amend, modify, or terminate any benefits programs as needed.

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