Eligibility Specialist

Lifeline Connections•Vancouver, WA

1d•Onsite

About The Position

Lifeline Connections is a community-based behavioral health organization that specializes in providing confidential and compassionate care to individuals who experience substance use and/or mental health conditions. Our Vision - As the premier provider of substance use and mental health services in the Pacific Northwest, we are respected and the most trusted resource for behavioral health treatment and whole-person care. We provide a comprehensive continuum of coordinated quality services, foster enduring relationships, and empower our communities to truly thrive. Our Mission - Through superior customer service, high quality programs, and well-trained and dedicated staff, we inspire hope and support lifesaving changes for people affected by substance use and mental health conditions. The Eligibility Specialist is responsible for ensuring accurate and timely verification of patient insurance coverage to support effective billing and revenue cycle operations. This role requires strong analytical thinking, attention to detail, and the ability to proactively identify and resolve eligibility issues. The Eligibility Specialist partners with internal teams, patients, and payers to ensure coverage is verified, documented, and aligned with billing requirements. This position does not provide clinical services.

Requirements

Strong attention to detail and accuracy
Effective verbal and written communication skills
Ability to work independently and manage multiple priorities
Strong organizational and time management skills
Customer service orientation
Analytical and problem-solving ability

Nice To Haves

Experience in insurance verification, medical billing, or revenue cycle operations preferred
Medical Billing and Coding certification or related education preferred
Experience with electronic health records (CareLogic preferred)
Proficiency in Microsoft Excel (sorting, filtering, basic analysis; advanced skills preferred)

Responsibilities

Accurately verifies and updates patient insurance eligibility and benefits using payer portals, phone, and other verification tools
Interprets insurance plans, coverage limitations, and authorization requirements to ensure claims are billable
Maintains accurate and complete patient demographic and insurance records to support clean claim submission
Identifies discrepancies and proactively resolves issues that may delay or impact reimbursement
Applies critical thinking to analyze complex insurance coverage details and resolve eligibility-related issues
Troubleshoots payer-related challenges and escalates appropriately when barriers cannot be resolved independently
Identifies patterns or recurring issues and communicates trends to leadership
Communicates clearly and professionally with patients, clinical staff, administrative teams, and insurance representatives
Partners with clinical and administrative teams to support authorization and pre-authorization processes
Provides timely updates and ensures alignment across teams regarding eligibility and coverage issues
Effectively manages work queues and prioritizes tasks to meet productivity expectations and deadlines
Completes follow-up activities (calls, portal updates, correspondence) in a timely and organized manner
Demonstrates accountability for maintaining workflow efficiency and minimizing delays
Maintains strict confidentiality and adheres to HIPAA and 42 CFR Part 2 regulations
Ensures all activities are documented accurately and in accordance with organizational policies
Stays current on payer requirements, regulatory updates, and internal procedures
Demonstrates reliability, accountability, and consistent attendance
Builds and maintains effective working relationships across departments
Supports team and organizational goals, including participation in process improvements and special projects