Eligibility & Benefits Analyst

Eligibility & Benefits Analyst

At MSC, we are dedicated to enhancing patient comfort and quality of life with over 75 years of experience and accredited by the Accreditation Commission for Health Care (ACHC). MSC is a 13-time recipient of the NorthCoast 99 Award as a Top Workplace to work! MSC is a two-time recipient of the prestigious National HME Excellence Award for Best Home Medical Equipment company in the US. In addition, MSC is very proud to announce its debut on the Inc. 5000 list in 2024, marking a significant milestone in our company's growth and success!

We are excited to announce that we are hiring for a full-time hybrid position. Work in our office location on Tuesdays, Wednesdays, and Thursdays, and enjoy the flexibility of remote work on other days. Benefits included!

Competitive Pay

Advancement Opportunities

Medical, Dental & Vision Insurance

HSA Account w/Company Contribution

Pet Insurance

Company provided Life and AD&D insurance

Short-Term and Long-Term Disability

Tuition Reimbursement Program

Employee Assistance Program (EAP)

Employee Referral Bonus Program

Social Recognition Program

Employee Engagement Opportunities

CALM App

401k (with a matching program) / Roth IRA

Company Discounts

Payactiv/On-Demand Pay

Paid vacation, Sick Days, YOU (Mental Health) Days and Holidays

Role Overview

The Eligibility & Benefits Analyst is responsible for verifying, reviewing, and confirming patient insurance eligibility and benefits information to support accurate intake, authorization, and billing processes. This role focuses on analyzing eligibility and benefits results produced by systems we use for eligibility, validating accuracy, and resolving discrepancies.

Responsibilities and Job Duties

Insurance Eligibility & Benefits Verification

Review and interpret insurance eligibility and benefits results presented by our platforms.

Confirm active coverage, benefit details, plan type, payer requirements, and patient financial responsibility.

Validate insurance information against source systems to ensure accuracy and completeness prior to authorization, service delivery, or billing.

Issue Resolution & Research

Identify discrepancies, missing information, or inconsistencies in eligibility and benefits results.

Research internal systems, payer portals, clearinghouses, and other available tools to locate or confirm correct insurance information.

Escalate complex or unresolved eligibility issues according to established workflows.

Patient & Payor Outreach

Conduct outreach to patients via phone or other communication methods to obtain or clarify insurance information.

Communicate with insurance carriers as needed to verify eligibility, benefits, or coverage details.

Document all outreach, findings, and updates clearly and accurately in designated systems.

Job Qualifications & Requirements

14 years of experience in insurance eligibility, benefits verification, healthcare intake, billing, or revenue cycle operations.

Strong understanding of health insurance concepts, including eligibility, benefits, plan structures, and payer terminology.

Experience working with eligibility platforms, payer portals, or revenue cycle systems (e.g., Brightree, Tennr or similar tools).

High attention to detail with the ability to interpret and reconcile insurance information from multiple sources.

Strong verbal and written communication skills, including comfort with patient and payer outreach.