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Mindful Behavioral Healthcare
Insurance Verification Specialist
Career Insights for Eligibility Specialist
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Scorecard
Based on Florida data
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What they do
An Eligibility Specialist provides assistance and information for people who apply for a government benefits program or health care program. Answers questions, assists with an application process, and reviews applications and relevant background information to determine eligibility. May assist eligible applicants with enrolling in a program.
$44,207 / year median in Florida
+17% projected growth
Job Description
-Insurance Verification Specialist is responsible for the pre-verification of insurance benefits for patients. The insurance verification process includes copays, deductibles, OOP, policy status, referral requirements, pre-existing clause, plan exclusions, authorizations, and any other items that affect cost and coverage -Ensures insurance coverage by telephone or web portal, resolves any issues with coverage, and escalates complicated issues to a supervisor or manager. Follows up on accounts that require further evaluation. • Reviews account balances for accuracy. -Performs clerical functions like uploading Explanation of Benefits, Treatment Plans, CFARS/FARS, etc. Follows up on accounts that require further evaluation and takes proper action.