Eligibility & Benefits Specialist

$21.00 - $22.00 hourly
  • Baker Search Group
  • San Carlos, CA, USA
  • Oct 03, 2018
Full time

Job Description

This client is an expanding National Health Services Company focused on Sleep Related Breathing Disorders. They have provided sleep care services for over 20 years with a comprehensive "continuum of care" that includes diagnostic sleep testing, titrations, and CPAP treatment for obstructive Sleep Apnea (OSA).

Eligibility & Benefits Specialist

Responsibilities include, but are not limited to:

  • Verify and explain medical benefits (commercial and government insurances) to patients
  • Submit and appeal denied medical insurance prior-authorizations for both commercial and government insurances
  • Determine the proper documentation for submitting prior-authorizations to commercial and government insurances
  • Communicate with patients regarding referral and prior-authorization status
  • Communicate with referral coordinator and Patient Service Centers regarding referrals
  • Communicate with Medical Billing Specialists regarding insurance changes and authorizations
  • Data entry into medical proprietary software
  • Using commercial and government insurance websites



  • 1-2 years' experience in a medical office environment is required
  • Must have strong working knowledge of interpreting benefits through varied commercial insurance companies
  • Excellent multi-tasking skills are critical
  • Strong computer skills required (Word, Excel, Outlook, billing software, Internet)
  • Experience using commercial and government insurance websites a strong plus, as well as experience with Brightree software

This position offers Excellent Benefits, including Medical, Dental and Vision, PTO, paid holidays and bonus incentives. 

When applying, please note that you saw the job posted on the NOVA Job Board. If you need help with your resumé, please see a NOVA Career Advisor.