Eligibility Verification (EV)

Scale Healthcare is hiring experienced professionals for the Eligibility Verification (EV) role within our US Healthcare Revenue Cycle Management (RCM) team. This position is critical for ensuring that patients' insurance coverage is confirmed and understood prior to service delivery. As an Eligibility Verification specialist, you will play a key role in preventing claim denials and ensuring accurate financial estimates for patients and providers.

Key Responsibilities

• Verify patient insurance eligibility and benefits using various payer portals, phone calls, and other tools.
• Obtain detailed information regarding co-pays, deductibles, co-insurance, and out-of-pocket maximums.
• Document all eligibility and benefit information accurately in the patient's record.
• Communicate any insurance limitations or exclusions to relevant internal departments.
• Prioritize verification requests based on urgency and scheduled appointments.
• Collaborate with billing and patient access teams to resolve any discrepancies.

Requirements

• Demonstrable experience in Eligibility Verification within the US Healthcare RCM sector.
• Proficiency in navigating insurance payer portals and understanding complex benefit structures.
• Strong organizational skills and meticulous attention to detail.
• Excellent verbal and written communication skills for interacting with insurance companies.
• Ability to work effectively in a high-volume environment while maintaining accuracy.
• Familiarity with medical terminology and healthcare administrative processes.

What We Offer

• An opportunity to contribute to a growing company in the healthcare RCM space.
• Access to learning and development programs for career advancement.
• A collaborative and supportive team environment.
• Competitive salary and benefits package.