Eligibility Specialist

Angels of Care Pediatric Home Health•McKinney, TX

2d•Remote

About The Position

The Eligibility and Benefits Representative plays a crucial role in ensuring the smooth onboarding of pediatric home healthcare patients by verifying insurance eligibility and benefits across multiple states. This position requires a detail-oriented professional with a strong understanding of various payor requirements, Medicaid policies, and private insurance benefits related to home healthcare services. The representative will communicate with insurance providers, patients, and internal teams to ensure accurate coverage details and assist in the authorization process. In this role, you will: Pull and analyze insurance eligibility within a timely manner. Communicate insurance changes with appropriate staff. Upload insurance documents to client’s profiles. Make outbound calls in regard to insurance changes and updates. Communicate issues as they arise to the team.

Requirements

High school diploma or equivalent required.
2+ years of experience in insurance verification, benefits coordination, or revenue cycle management within a healthcare setting, preferably in home healthcare or pediatrics.
Strong understanding of Medicaid, MCOs, and commercial insurance processes, including eligibility verification and prior authorization requirements.
Excellent communication and customer service skills, with the ability to interact professionally with patients, families, and healthcare professionals.
Proficiency in electronic health records (EHR) and insurance verification platforms.
Strong attention to detail and ability to manage multiple tasks in a fast-paced environment.
Knowledge of HIPAA regulations and compliance requirements.