[Remote] Insurance Eligibility Coordinator

Note: The job is a remote job and is open to candidates in USA. Senior Care Therapy is seeking an Insurance Eligibility Coordinator who is responsible for verifying patient insurance coverage and ensuring accurate benefit information. The role involves working closely with patients and insurance carriers to confirm eligibility, resolve discrepancies, and support efficient revenue cycle operations.

Responsibilities

• Verify patient insurance eligibility and benefits using electronic systems, payer portals, and direct insurance carrier communication
• Accurate document coverage details, copayments, deductibles, prior authorization requirements, and plan limitations. Prepare and submit claims in a timely and accurate manner
• Obtain Authorizations as required
• Identify and correct rejected claims for prompt resubmission
• Submit and follow up on authorization requests
• Follow up on denied or unpaid claims and work to resolve discrepancies
• Post payments and adjustments to patient accounts in a timely manner
• Communicate with insurance companies and internal staff regarding billing inquiries or issues
• Maintain up-to-date knowledge of payer rules, policy changes, and medical coverage guidelines
• Protect patient privacy and maintain compliance with HIPAA and organizational standards
• Support revenue cycle improvement initiatives related to eligibility and insurance workflows
• Participate in team meetings and contribute to quality improvement initiatives
• Adhere to practice policies, procedures, and protocols including confidentiality
• Other tasks as assigned

Skills

• High School diploma or equivalent required
• 1-2 years of experience in medical insurance verification, medical billing, or related roles
• Strong understanding of insurance plans, terminology, HMOs, PPOs, Medicare/Medicaid and commercial payer policies in NJ, NY, & PA
• Excellent communication, customer service, and problem-solving skills
• Proficiency with medical practice management software, EHR systems, and payer portals
• Ability to multitask and work in a fast-paced environment
• Strong Knowledge of Microsoft Office Suite
• Comfortable working independently and collaboratively
• Outstanding problem solver and analytical thinking skills
• Attention to detail and ability to prioritize
• Ability to maintain confidentiality
• Experience in Behavioral health is preferred

Company Overview