ABOUT US

We are a results-oriented management consulting firm serving clients involved in the healthcare, customer service and transportation industry, providing services such as scheduling, accounts receivable, recruiting, HR, and logistics. Our experienced teams create value for clients through growth strategy, operation improvement, financial restructuring, and acquisition integration. We've been working side by side with clients, fostering long-term relationships, and delivering tangible, sustainable results.

JOB DESCRIPTION:

As an Insurance Eligibility Specialist you will verify insurance coverage including health, auto, and workers' compensation prior to patient appointments or procedures.

This role involves contacting insurance companies to confirm active policy status, reviewing and entering in the database documents such as insurance cards, accident reports, and attorney letters. The specialist will also check for prior authorization requirements, policy limits, deductibles, and co-pay responsibilities.

RESPONSIBILITIES:

• Verify insurance coverage for patients prior to appointments or procedures. (Health insurance, auto insurance, workers compensation, etc.)
• Contact insurance companies to confirm active policy status and/or Policy holder information.
• Coverage details related to medical payments.
• Collect and review insurance cards, claim information, accident reports, and attorney letters.
• Enter and update insurance details into ECW platform.
• Determine if prior authorization is required for services.
• Verify policy limits, deductibles, and co-pay responsibilities.
• Collaborate with front desk staff, case managers, and billing teams.
• Contact patients, adjusters, or attorneys when needed for missing or unclear information.
• Notify clinical and administrative teams of any eligibility issues or coverage gaps.

REQUIREMENTS

• Fluency in English and Spanish with excellent verbal and written communication skills
• Bachelor's degree from an accredited university or college in related field (preferred)
• Prior experience of customer service (ideal healthcare).

SKILLS

• Must be detail-oriented.
• Tolerance to work under pressure.
• High execution capability.
• Responsible.
• Follow up on patients and schedule appointments if needed.
• Strong communication skills.
• Adaptability.
• Effective listening.

WE OFFER

• Competitive pay and benefits (based in abilities and experience)
• By law benefits
• Breakfast and lunch service included
• Excellent work environment
• Flexible time-off