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.
Key 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 e...