Insurance Eligibility Specialist (Telehealth)

TEKsystems•Mountain View, CA

7d•$23 - $23•Remote

About The Position

The Insurance Eligibility Specialist plays a critical role in supporting both members and providers by managing insurance-related inquiries and ensuring accurate coverage information. This role operates in a high-volume environment and requires strong attention to detail, problem-solving skills, and clear communication. The role progression begins with email-based support focused on foundational ticket handling, gradually taking on more complex and investigative cases, and transitioning into limited phone-based support once proficiency is established.

Requirements

2+ year of healthcare experience
Experience working with health plans
Knowledge of: billing, EOBs, deductibles, copays, coinsurance
Flexible and adaptable in a fast-changing environment
Ability to take feedback well
Comfortable with shifting priorities and evolving processes

Responsibilities

Manage a high volume of inbound insurance-related tickets from members and providers
Respond to inquiries primarily via email, with some phone support as responsibilities expand
Assist providers with questions related to: Accepted insurance plans, Client volume and capacity, Payor status and credentialing updates
Support members with inquiries including: Insurance discrepancies and coverage issues, Adding or updating insurance information, Complex billing, technical, or investigative concerns
Troubleshoot and resolve escalated or non-routine issues with accuracy and efficiency
Maintain detailed documentation of interactions and resolutions