Medical Eligibility Specialist

Do you love helping people?  Are you looking for a career move? Randstad is seeking an Eligibility Specialist for a client in the Buckhead area.  The person would be responsible for the timely and accurate verification of patient insurance benefits and the determination of program eligibility. Given the chronic nature of nephrology care, this role is critical in coordinating coverage for long-term treatments, ensuring that financial barriers do not disrupt patient care while securing the practice’s revenue stream. Experience:

• Minimum of 2–3 years in medical insurance verification or patient access.
• Experience in a specialty practice (Nephrology, Oncology, or Dialysis) is highly preferred.
• Knowledge: Deep understanding of Medicare Part B and D, Medicaid, and private PPO/HMO plans. Familiarity with CPT/ICD-10 codes related to kidney disease is a plus.
• Technical Skills: Proficiency in EMR systems and online payer portals (e.g., Availity, Navinet, Medicare FISS).
• Communication: Exceptional interpersonal skills; must be able to discuss sensitive financial matters with patients experiencing chronic illness with empathy and clarity.
• Attention to Detail: High accuracy in data entry to minimize claim rejections.

Apply directly to the posting for consideration.  Once you have completed the prescreening questionnaire you'll be able to get on one of our recruiter's calendar.  No emails please as I'm not the recruiter for this position.  TY  

salary: $21 - $23 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School

Responsibilities

• Insurance Verification: Verify active coverage for all scheduled patients, including commercial payers, Medicare, Medicaid, and VA benefits.
• Medical Authorizations: Obtain prior authorizations for specialized services such as ultrasound, injections (e.g., Aranesp/Epogen), and inpatient consultations.
• Coordination of Benefits (COB): Manage complex COB scenarios, particularly for patients with ESRD (End-Stage Renal Disease) where Medicare coordination rules are highly specific.
• Financial Counseling: Meet with patients to explain their out-of-pocket responsibilities, deductible statuses, and co-insurance requirements.
• Program Assistance: Identify patients eligible for secondary assistance, pharmaceutical manufacturer programs, or the American Kidney Fund (AKF) for premium assistance.
• Data Integrity: Update and maintain accurate demographic and insurance information within the Electronic Medical Record (EMR) and billing systems.
• Claims Support: Collaborate with the billing team to resolve denials related to "eligibility not found" or "no authorization on file".

Skills

• Physician Referrals (1 year of experience is required)
• Medical Insurance Verification (2 years of experience is required)
• Patient Eligibility (2 years of experience is required)
• Medical Claims Support (2 years of experience is required)
• Patient Advocacy (1 year of experience is required)

Qualifications

• Years of experience: 2 years
• Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact View email address on randstadusa.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.