Member Financial Services Specialist

Eleanor Health

21h

About The Position

The ideal candidate for this position is a proactive self-starter who demonstrates critical and creative thinking to resolve issues effectively, performs well with limited reliance on detailed workflows, and adapts quickly as priorities or processes evolve. This role requires the ability to work efficiently under pressure, conduct thorough independent research, determine appropriate courses of action, and leverage multiple tools to support accurate, timely decision-making. This position works collaboratively with the RCM team and cross-functional departments to complete financial clearance, manage member balances, and resolve member-facing claims issues, including coordination of benefits (COB). A strong understanding of claim details and COB resolution is highly valued, and experience with third-party liability (TPL) is preferred. The candidate will also work proactively to reduce bad debt and ensure timely resolution of outstanding balances. The selected candidate must maintain strong focus and engagement with minimal distraction, demonstrate excellent attendance and punctuality, and exhibit exceptional attention to detail. Success in this role requires strong information retention, the ability to recall and apply policies, procedures, and recent updates in real time, and effective conflict de-escalation and negotiation skills. Additionally, the candidate must be capable of professionally communicating benefit interruptions or eligibility determinations to community members with clarity, empathy, and confidence.

Requirements

Minimum of 3 years’ experience working in a healthcare customer service role, with focus on resolving financial issues while providing high quality customer experience
Strong communication skills
Ability to work in a busy, high-volume environment
Knowledge of billing and collection practices required
Experience with claims follow up, processing patient payments, reading and understanding insurance correspondence and EOBs
The ability to work in a fast-paced and sometimes ambiguous environment

Nice To Haves

Behavioral Health and substance use disorder experience preferred
Experience with value-based care or alternative payment models preferred
Athena experience preferred

Responsibilities

Act as financial counselor to community members by explaining their benefits and financial responsibility in a clear, concise manner
Set appropriate expectations with community members regarding Eleanor Health policies for payment
Handle communication effectively and demonstrate empathy with all community members
Resolve community member issues and questions related to their outstanding balance and insurance coverage; ensure plan for payment is established, documented, and upheld
Demonstrates strong expertise in managing the complexities of financial clearance, with confidence in assisting members across multiple communication channels, including phone, secure messaging, and email.
Comfortable engaging with diverse and often complex populations, consistently exhibiting patience, sound judgment, and strong problem-solving abilities.
Committed to delivering high-quality service and a positive member experience in every interaction.
Assess current workflows and surface opportunities to drive efficiency and improve performance against key metrics
Collect outstanding community member balances
Collaborate and communicate with RCM, Clinic, and Access teams to ensure shared understanding of opportunities to enhance processes and barriers to success
Utilize data to inform prioritization of work
Research and respond to insurance denials
Review insurance remittances for rejections and respond with corrective action
Fax, scan or email correspondence to patients
Attend weekly team meetings and monthly staff meetings
Assist in training new team members when appropriate
Perform other duties as assigned by manager

Benefits

Generous Paid Time Off (prorated for new employees)
12 Vacation days
12 Wellness (Sick) days
3 Floating holidays
9 Company-observed holidays
Jury Duty, Voting Leave, and other forms of paid time off may be available
Eleanor-paid medical and dental insurance plans, with affordable vision coverage
401(k) plan with 3% match
Short-term disability
Long Term Disability - Picks up where Short Term Disability leaves off (employee paid).
Life Insurance - Both Eleanor and employee-paid options are available.
Family Medical Leave - Eleanor Health’s Paid Family & Medical Leave (“PFML”)
Wellness Perks & Benefits - Mental Health is important to us
Mindfulness App Reimbursement
EAP with eight face-to-face sessions
Virtual health and wellness visits covered by our medical plan.