Eligibility Specialist

We are looking for a detail-oriented and customer-focused Eligibility Specialist to join our Durable Medical Equipment (DME) team. In this role, you will be responsible for verifying insurance coverage, determining patient eligibility for DME services, and ensuring accurate documentation to support medical necessity and compliance with payer requirements. Responsibilities Verify insurance benefits and eligibility for patients requiring durable medical equipment. Obtain prior authorizations and ensure all required documentation is complete and accurate. Communicate with insurance companies, healthcare providers, and patients regarding coverage and requirements. Maintain up-to-date knowledge of payer policies related to DME, including Medicare, Medicaid, and private insurers. Accurately enter and update patient and insurance information in the system. Assist with claim follow-up and resolve eligibility-related denials. Ensure compliance with HIPAA and other regulatory requirements. Other duties as required Experience Previous experience in an office setting is preferred. Familiarity with medical terminology is essential for effective communication within the healthcare environment. HCPC and ICD 10 knowledge Experience in a medical office is highly desirable. Strong organizational skills with attention to detail to manage multiple tasks efficiently. Excellent communication skills to interact effectively with patients and healthcare professionals. Join our dedicated team as an Eligibility Specialist where your skills will contribute to improving patient access to essential medical equipment and supplies services. Job Type: Full-time Benefits: 401(k) matching Paid sick time Paid time off Schedule: 8 hour shift Day shift Monday to Friday Ability to Commute: Malden, MA 02148 (Required) Ability to Relocate: Malden, MA 02148: Relocate before starting work (Required) Work Location: In person