Insurance Verification Specialist

Posted yesterday

medical services companyLewis Center (OH)

Insurance Claims and Policy Processing Clerks All Other Insurance Related Activities

SENIORITY

Senior

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About the role

Eligibility & Benefits Analyst At MSC, we are dedicated to enhancing patient comfort and quality of life with over 75 years of experience and accredited by the Accreditation Commission for Health Care (ACHC). MSC is a 13-time recipient of the NorthCoast 99 Award as a Top Workplace to work! MSC is a two-time recipient of the prestigious National HME Excellence Award for Best Home Medical Equipment company in the US. In addition, MSC is very proud to announce its debut on the Inc. 5000 list in 2024, marking a significant milestone in our company's growth and success! We are excited to announce that we are hiring for a full-time hybrid position. Work in our office location on Tuesdays, Wednesdays, and Thursdays, and enjoy the flexibility of remote work on other days. Benefits included! Competitive PayAdvancement Opportunities Medical, Dental & Vision InsuranceHSA Account w/Company Contribution Pet Insurance Company provided Life and AD&D insurance Short-Term and Long-Term Disability Tuition Reimbursement ProgramEmployee Assistance Program (EAP) Employee Referral Bonus Program Social Recognition ProgramEmployee Engagement OpportunitiesCALM App 401k (with a matching program) / Roth IRACompany Discounts Payactiv/On-Demand PayPaid vacation, Sick Days, YOU (Mental Health) Days and Holidays

Role Overview: The Eligibility & Benefits Analyst is responsible for verifying, reviewing, and confirming patient insurance eligibility and benefits information to support accurate intake, authorization, and billing processes. This role focuses on analyzing eligibility and benefits results produced by systems we use for eligibility, validating accuracy, and resolving discrepancies.

Responsibilities and Job Duties

Insurance Eligibility & Benefits Verification: Review and interpret insurance eligibility and benefits results presented by our platforms. Confirm active coverage, benefit details, plan type, payer requirements, and patient financial responsibility. Validate insurance information against source systems to ensure accuracy and completeness prior to authorization, service delivery, or billing.

Issue Resolution & Research: Identify discrepancies, missing information, or inconsistencies in eligibility and benefits results. Research internal systems, payer portals, clearinghouses, and other available tools to locate or confirm correct insurance information. Escalate complex or unresolved eligibility issues according to established workflows.

Patient & Payor Outreach: Conduct outreach to patients via phone or other communication methods to obtain or clarify insurance information. Communicate with insurance carriers as needed to verify eligibility, benefits, or coverage details. Document all outreach, findings, and updates clearly and accurately in designated systems. Job Qualifications & Requirements 14 years of experience in insurance eligibility, benefits verification, healthcare intake, billing, or revenue cycle operations. Strong understanding of health insurance concepts, including eligibility, benefits, plan structures, and payer terminology. Experience working with eligibility platforms, payer portals, or revenue cycle systems (e.g., Brightree, Tennr or similar tools).High attention to detail with the ability to interpret and reconcile insurance information from multiple sources. Strong verbal and written communication skills, including comfort with patient and payer outreach.

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