Demographics Eligibility Specialist

Demographics Eligibility Specialist

As a Demographics Eligibility Specialist, you'll be the go-to expert for verifying insurance, maintaining up-to-date patient records, and making sure the billing process runs smoothly. Your attention to detail will help reduce delays, improve accuracy, and ensure patients receive the care they need without unnecessary stress.

Essential Duties & Responsibilities

• Collaborate with providers and facilities to collect patient face sheets and required information.
• Verify insurance coverage through Onesource or directly with insurance carriers.
• Enter and maintain accurate demographic and insurance data in the billing system.
• Update insurance details for existing patients as needed.
• Manage documentation and process billing in a timely, accurate manner.
• Obtain prior authorizations when required by insurance plans.

Qualifications

• High School Diploma or equivalent required.
• 2+ years of medical billing experience with strong knowledge of insurance processes.
• Experience working with Medicare, Medicaid, private insurance, and managed care plans.
• Proficiency with Excel, Outlook, and general computer skills.
• Strong time management, organizational, and problem-solving skills.
• Detail-oriented, accurate, and dependable with a professional work ethic.