Eligibility Specialist - Full Time - Germantown, TN

West Cancer Center•Germantown, TN

13h

About The Position

The Eligibility Specialist ensures that all patient insurance and referral information is accurate, current, and correctly entered in the system. This role is responsible for verifying benefits, resolving claim issues, and supporting patients with benefit-related questions, working collaboratively with internal teams to ensure a seamless patient experience.

Requirements

High school diploma or GED required
Minimum of 2–3 years of experience in insurance verification in a medical environment
Data entry skills required; proficiency in 10-key by touch
Strong organizational and follow-up skills
Excellent written and verbal communication skills
Strong customer service and interpersonal skills
Ability to analyze situations and resolve issues quickly and accurately
Ability to prioritize and handle multiple tasks in a fast-paced environment
Ability to collaborate effectively across multiple teams
Proficiency in computer applications, including EMR, PM systems, Microsoft Office, Outlook, and web portals
Knowledge of insurance verification, patient eligibility, referrals, and healthcare billing processes

Responsibilities

Verify insurance benefits for new patients, add-ons, and hospital surgeries
Verify benefits on existing patients and update records as needed
Enter and validate patient demographics and insurance in Practice Management (PM) and EMR systems
Enter and verify copayments and financial information
Contact primary care physicians or patients to obtain referrals
Handle patient inquiries regarding insurance coverage and benefits
Assist in explaining financial screening and application processes, collaborating with Financial Advocates
Work closely with West Cancer Foundation for screening and approvals
Assist patients who are uninsured in connecting with appropriate financial support teams
Manage STAT add-on list daily
Review and process scanned insurance cards and maintain accurate documentation
Monitor group inbox tasks in EMR for eligibility and referral issues
Communicate effectively with patients to explain coverage, copays, deductibles, out-of-pocket expenses, and referral requirements
Collaborate with Front Desk, Medical Records, Business Office, Radiology, Nursing, and other internal teams to ensure accurate and timely insurance verification
Address eligibility and referral issues raised by staff and leadership in a timely manner
Perform all other duties as assigned
Some travel to satellite offices may be required