The Billing and Eligibility Specialist manages key revenue cycle functions, including client eligibility monitoring, financial registration, prior authorizations, claims management, and general revenue cycle support.
This role focuses on maintaining accurate and continuous patient insurance coverage, with a primary emphasis on Medicaid eligibility management. It helps prevent revenue loss related to coverage gaps, policy changes, and Medicaid redetermination requirements.
The position works closely with front-end operations, clinical teams, and the revenue cycle department to identify and resolve coverage issues before, during, and after service delivery.
Qualifications
- High school diploma or equivalent required; associate or bachelor’s degree preferred
- Minimum 2 years of experience in the healthcare industry
- Experience with Medicaid, Medicare, commercial insurance, and/or managed care organizations
- Knowledge of eligibility verification processes, insurance portals, and clearinghouses
- 1–3 years of training and experience in revenue cycle functions preferred
- Working knowledge of HIPAA regulations and strict confidentiality requirements
- Understanding of medical terminology
- Strong Microsoft Office skills, especially Excel, Outlook, and Word
- Experience with electronic health records systems
- Ability to investigate problems and develop and communicate solutions
- Professional communication skills with staff and clients
Benefits
- Competitive salary
- Blue Cross/Blue Shield medical coverage: HMO and PPO
- Dental and vision insurance options
- Company-paid life and LTD insurance
- Voluntary benefits including pet insurance, AD&D, life, critical illness, and short-term disability
- 11 paid holidays
- Paid vacation, sick time, and personal days
- 403(b) plan
- In-house training and CEUs
- Employee Assistance Network
- Support for pursuing clinical licensure, including financial support and time off
- Career growth and development opportunities
Location
Chicago, Illinois, US
Employment Type
Full-time
Experience Level
Associate
Salary Range
$50,000 - $55,000
Remote work allowed
Yes
Posted
2 weeks ago