Top 31207 Eligibility specialist Jobs in Usa

Member Financial Specialist – Eligibility & COB
Groups Recover Together, Inc. —Remote
- $19.05 - $25.16 an hour
- Full-time
- Remote
- Public speaking
- Bachelor's degree
- Fingerprint clearance
P&C Commissioning Specialist
Premier Power Maintenance —Indianapolis, IN
- Overtime
- Microsoft Excel
- Microsoft Outlook
- Pass drug screening
Physician Senior Specialist
Pantex —Amarillo, TX
- Full-time
- Medicine
- 7 years
- Management
- Health insurance
- Tuition reimbursement
Maternal-Fetal Medicine Specialist
Jamaica Hospital Medical Center —Richmond Hill, NY
- $450,000 - $700,000 a year
- Full-time
- Medicine
- Doctoral degree
- Inpatient
- Health insurance
- Dental insurance
Quick Apply
Landscape Maintenance Specialist (Estate Gardening)
Nussbaum Group —Redmond, WA
- $25 - $33 an hour
- Temporary
- Bilingual
- Background check
- Pass drug screening
- Paid holidays
- Health insurance
Quick Apply
Operational Resources Specialist
South Dakota State Government —Pierre, SD
- $28.54 - $35.66 an hour
- Online Application
- Mid-level
- Office
- US work authorization
- Paid holidays
- Health insurance
Medical Billing Specialist
Genesee Valley OB/GYN —Penfield, NY
- $19 - $21 an hour
- Full-time
- Mid-level
- Office
- High school diploma or GED
Quick Apply
Medical Billing Specialist
Mat-Su Surgical Associates, APC —Wasilla, AK
- From $25 an hour
- Full-time
- Private practice
- Surgery
- HIPAA
- Paid holidays
- Health insurance
Quick Apply
Bilingual Crisis Professional/Therapist - Mobile
SummitStone Health Partners —Fort Collins, CO
- $24.04 - $46.68 an hour
- Weekends as needed
- Acute care
- Bilingual
- LMFT
- 403(b) matching
- Disability insurance
Quick Apply
Shipbuilding Expert
Massachusetts Maritime Academy —Buzzards Bay, MA
- $75,000 - $80,000 a year
- Part-time
- Background check
- Mid-level
- Analysis skills
Maternal-Fetal Medicine Specialist
Flushing Hospital Medical Center —Flushing, NY
- $450,000 - $700,000 a year
- Full-time
- Medicine
- Doctoral degree
- Inpatient
- Health insurance
- Dental insurance
Quick Apply
Pediatric Psychologist - Neurodevelopmental Evaluation Specialist
Vibrant Minds - Applied Behavioral Pediatrics —Medford, OR
- $65 - $120 an hour
- Part-time
- Hybrid work
- Bilingual
- Writing skills
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
Mental Health Specialist II - Intensive In-Home Behavioral Health Treatment
Coos Health & Wellness —North Bend, OR
- $6,461 - $7,558 a month
- Full-time
- Bilingual
- Nursing
- Mid-level
- Loan repayment program
- Relocation assistance
Quick Apply
Software Test Specialist
Abaco Strategy LLC —Fort Huachuca, AZ
- $21 - $24 an hour
- Full-time
- Mid-level
- Office
- JavaScript
Quick Apply
11d
Sales Specialist
ALS Global —Reno, NV
- $54,000 - $59,000 a year
- Online Application
- Clean driving record
- Mid-level
- Office
- Disability insurance
- Health insurance
6d
PTC Program Training Specialist
Woodfords Family Services —Westbrook, ME
- $49,000 - $55,000 a year
- Full-time
- Classroom
- Microsoft Excel
- Microsoft Outlook
- Paid holidays
- Disability insurance
EB1A Expert - Immigration Attorney
Gibbs Houston Pauw —Seattle, WA
- $90,000 - $130,000 a year
- Full-time
- Hybrid work
- Writing skills
- Employment & labor law
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Occupancy Specialist for LIHTC & Section 8 Property
Orbach Affordable Management, LLC —Wilkes-Barre, PA
- $19 - $21 an hour
- Full-time
- Microsoft Word
- Microsoft Excel
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
10d
Home Based Specialist (Master's degree)
Montcalm Care Network —Stanton, MI
- $56,170 - $89,878 a year
- Full-time
- Nursing
- Adults
- Mid-level
- Loan repayment program
- Disability insurance
Quick Apply
Nurse Practitioner (NP) Clinical Research Specialist (5+ Yrs Experience)
Patient First Clinical Trials —Lutherville, MD
- $70 - $80 an hour
- Part-time
- Patient monitoring
- 5 years
- Urgent Care
Quick Apply

I want to receive the latest job alert for eligibility specialist in usa

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

eligibility specialist jobs near usa

Member Financial Specialist – Eligibility & COB

Groups Recover Together, Inc. -
Remote

Apply Now

Job Details

Full-time
$19.05 - $25.16 an hour

Qualifications

Medicare
Medicaid health insurance
Telehealth experience
Medical billing and coding communication with insurance companies
Medicaid
Insurance provider collaboration
Patient interaction
Video conferences (communication methods)
Experience working with individuals with substance use disorders
Customer interaction during outreach

Full Job Description

Overview:

As a Member Financial Specialist – Eligibility & COB Focus, you will play a vital role in resolving Coordination of Benefits (COB) denials, addressing complex eligibility and coverage issues, and ensuring accurate and timely updates to member accounts. You will work closely with members and insurance carriers to resolve discrepancies, educate members about their benefits, and support initiatives that promote clean claims and reduce financial barriers to care.

The Member Financial Support function ensures that patients have a clear and consistent understanding of their financial responsibilities, supports accurate claims processing from the start of care, enforces transparent payment policies, and helps make care affordable and accessible to all.

You will also contribute to the organization’s mission and values by bringing a strong sense of purpose, empathy, and teamwork to every interaction and workflow.

Responsibilities:

Essential Functions:

Investigate and resolve COB denials by communicating directly with insurance carriers and members
Conduct outreach to members to gather and update insurance details, verify coverage, and provide education on next steps
Support special projects related to eligibility changes, contract updates, and coverage transitions
Accurately update member accounts with verified insurance data, and notify members of any changes in benefits or financial responsibilities
Perform routine and ad-hoc reporting to identify trends in COB denials, eligibility issues, and coverage discrepancies
Run, interpret, and act on data reports to support operational improvements and targeted outreach
Communicate professionally with members and insurance companies via phone, video, and written correspondence
Review and process documents related to coverage updates, COB forms, and payer communications
Maintain a strong understanding of insurance policies, benefits structures, and patient responsibility guidelines

Other Duties and Responsibilities:

Perform other duties as assigned as the role and company evolve

Rate range: $19.05 - $25.16 per hour.

Qualifications:

Knowledge, Skills, and Abilities:

Mission-driven: You are deeply invested in patient success and committed to advancing the organization’s mission
Strong communicator and culture-bearer: You represent the organization’s values in every member interaction and communicate clearly, confidently, and with cultural sensitivity
Adaptable in fast-paced environments: You thrive in dynamic settings and can respond quickly to member needs
Collaborative: You excel at building strong relationships across teams and working toward shared goals
Data-savvy: You enjoy using data to evaluate performance and inform decision-making
Innovative thinker: You can challenge the status quo and propose creative, practical solutions
Highly organized: You manage multiple priorities and moving pieces with precision and consistency
Flexible and resourceful: You navigate ambiguity and rapid change with ease and professionalism
Self-directed: You are comfortable working independently and exercising sound judgment
Technologically proficient:
- Comfortable operating an EMR, RCM and Microsoft Office/Google Products
- Able to use video conferencing platforms and ticketing systems
- Able to operate effectively in a remote environment
Quick learner: Able to rapidly understand new insurance plans, payer processes, and internal tools
Professional discretion: You handle sensitive information responsibly and ethically

Compliance: Understand and adhere to the organization’s Code of Conduct

Qualifications & Requirements:

Bachelor’s degree or equivalent combination of education and experience required
Minimum of 2 years of direct patient-facing experience in patient access, financial counseling, or utilization management; experience in SUD/Behavioral Health strongly preferred
Experience with Apero is a plus
Prior experience speaking with SUD/Behavioral Health patients about coverage, benefits, and patient responsibility
Familiarity with working via telehealth
Comfortable communicating directly with payers and navigating insurance organizations
Strong working knowledge of commercial, Medicare, and Medicaid behavioral health/SUD plans
Experience in a high-growth, dynamic environment is strongly preferred
Access to reliable internet and phone services (minimum 40 Mbps download / 10 Mbps upload with strong Wi-Fi signal at remote location)
Must meet all pre-employment requirements, which may include fingerprinting, drug testing, health screenings, and background checks based on state-specific guidelines

Apply Now

Refine Your Search

eligibility specialist jobs in usa

Member Financial Specialist – Eligibility & COB

P&C Commissioning Specialist

Physician Senior Specialist

Maternal-Fetal Medicine Specialist

Landscape Maintenance Specialist (Estate Gardening)

Operational Resources Specialist

Medical Billing Specialist

Medical Billing Specialist

Bilingual Crisis Professional/Therapist - Mobile

Shipbuilding Expert

Maternal-Fetal Medicine Specialist

Pediatric Psychologist - Neurodevelopmental Evaluation Specialist

Mental Health Specialist II - Intensive In-Home Behavioral Health Treatment

Software Test Specialist

Sales Specialist

PTC Program Training Specialist

EB1A Expert - Immigration Attorney

Occupancy Specialist for LIHTC & Section 8 Property

Home Based Specialist (Master's degree)

Nurse Practitioner (NP) Clinical Research Specialist (5+ Yrs Experience)

I want to receive the latest job alert for eligibility specialist in usa

Related Searches

Explore jobs in more locations

Essential Functions:

Other Duties and Responsibilities:

Knowledge, Skills, and Abilities:

Job Seeker Tools

Employer Tools

Browse

Stay Connected