Eligibility Specialist

Hours: Monday - Friday, 8:30 AM - 5:00 PM EST

Job Summary:

Beal Wellness is seeking a detail-oriented and adaptable Eligibility Specialist to join our team. This remote position requires strong analytical skills, excellent communication abilities, and experience working with commercial insurance, Medicaid, Medicare, and workers' compensation. As an Eligibility Specialist, you will play a vital role in ensuring patients receive seamless care by verifying insurance coverage, assisting with billing inquiries, and securing prior authorizations. This role demands a high level of accuracy, the ability to follow instructions, and a willingness to accept and implement feedback.

Key Responsibilities:

Verify insurance eligibility for patients using eClinicalWorks (eCW), Luma, and various insurance portals.
Maintain accurate and up-to-date patient financial records.
Upload and manage patient insurance cards and IDs in eCW.
Communicate with patients via text and phone to clarify insurance coverage and answer billing-related questions.
Review and interpret patient balances, billing alerts, and coordination of benefits.
Process and document patient copayments, partial payments, and credit balances.
Set up and manage patient payment plans, ensuring adherence to minimum payment thresholds.
Generate and communicate patient cost estimates to patients
Obtain prior authorizations for specific visit types.

Qualifications & Skills:

Minimum of 2 years of experience in medical billing, insurance verification, or a related field.
Strong English skills and clear verbal communication are required.
Experience with eClinicalWorks (eCW) and Luma preferred.
Strong understanding of commercial insurance, Medicaid, Medicare, and workers’ compensation.
Ability to quickly learn and navigate multiple insurance portals.
High level of accuracy and attention to detail.
Must be willing to speak up when they have questions and communicate issues efficiently.
Excellent communication skills, both written and verbal.
Ability to adapt to feedback and follow structured processes.
Strong organizational and problem-solving skills.
Ability to work independently and meet deadlines in a remote setting.

Why Join Beal Wellness?

Work remotely while being part of a supportive and collaborative team.
Gain experience in a fast-growing mental health practice.
Develop expertise in insurance eligibility and patient financial services.