Eligibility verification Spectialist

Job Description

Job Summary: We are seeking a detail-oriented Eligibility & Verification Specialist to join our RCM team. The ideal candidate will have 1–2 years of hands-on experience in verifying patient insurance coverage and ensuring accurate eligibility information prior to services being rendered. You will play a critical role in optimizing revenue by reducing claim denials and improving the front-end cycle of billing. Required Skills and Qualifications: 1–2 years of experience in eligibility and insurance verification within the RCM process.Strong understanding of commercial and government insurance plans (Medicare, Medicaid, etc.).Familiarity with major payer portals (Availity, Navinet, etc.).Excellent communication and interpersonal skills for coordination with payers and internal teams.Proficiency in working with EHRs and practice management systems.Strong attention to detail and accuracy in data entry and recordkeeping. Verify patient insurance eligibility and benefits through online portals or by calling payers.Validate active coverage, co-payments, deductibles, plan limitations, and pre-authorization requirements.Proactively identify potential issues that could lead to claim rejections or payment delays.Ensure HIPAA compliance and safeguard patient confidentiality at all times.