Insurance Eligibility Specialist Ii

Insurance Eligibility Specialist II - Brightside Health - 100% Remote in U.S.

Brightside Health delivers life-saving virtual mental healthcare to everyone who needs it. We are powered by proprietary AI, purpose-built technology, a world-class clinician network, and a care model that rivals the best of in-person treatment. When combined with precision psychiatry and leading-edge therapeutic techniques, we’re able to improve outcomes for those with mild-to-severe clinical depression, anxiety, and other mood disorders.

We take an action-oriented, purposeful approach with everything we do and seek out team members who value collaboration and thoughtful prioritization. As a result, our organization is looking for the brightest and most innovative talent in the industry. We can promise you that, as a member of the Brightside team, you’ll have the opportunity to collaborate alongside smart and driven people while growing your professional skills.

We are looking for an experienced Eligibility Specialist II to help us successfully launch, manage, and scale our insurance offering in the market. You will be responsible for resolving member eligibility inquiries and working across multiple departments. We're looking for a self-starter who can work productively under tight deadlines without compromising attention to detail. This individual should be very comfortable working in Excel and have a natural drive for putting order to unstructured information processes.

What you’ll be doing as Eligibility Specialist II:

• Have knowledge of EDI 270/271 transactions and insurance eligibility verification Have strong work ethic, resourcefulness, and the motivation to succeed
• Are able to accurately calculate figures and reconcile accounts
• Have good organizational, multi-tasking, and time management skills, with excellent attention to detail.
• Are an effective oral and written communicator
• Can take initiative and thrive in a semi-structured and dynamic work environment
• Have experience working with insurance companies in the healthcare provider industry
• Take a proactive approach to identify and resolve issues
• Are passionate about helping patients obtain access to mental health care
• Have advanced Excel skills, with the demonstrated ability to write formulas, perform VLOOKUP, pivot tables, etc.

Requirements:

• 3-5 years previous experience in medical billing, current A/R & experience in patient services a plus.
• Work with billing and engineering teams to continuously improve upon current eligibility verification processes, adapting processes to frequent changes in technology and/or payer requirements
• Meet quality and performance standards for all eligibility projects
• Participate in special projects and provide ad hoc analytical eligibility support as needed
• Support day-to-day verification of accurate member eligibility and insurance coverage across multiple payer plans and systems
• Maintain knowledge of industry standards for insurance verification Understand and adhere to HIPAA policies, procedures, and regulations, maintaining strict confidentiality
• Perform extensive data entry
• Review, update and maintain accurate eligibility data in our information systems Maintain accurate member eligibility status in our information systems, reconciling information as needed
• Resolve eligibility inquiries and create a process to support cross-function information sharing around outcomes

Benefits:

• Life Insurance & Short / Long Term Disability
• Parental Leave
• 15 Days PTO
• A competitive salary
• Work remotely and whatever schedule works best for you
• Fully paid for comprehensive health care (medical, dental, vision)
• Pet Insurance
• 401k Plan
• Additional memberships and perks

Final offer amounts are determined by multiple factors including geographic location as well as candidate experience and expertise. If you have questions on compensation bands, please ask your recruiter.

Brightside Health is committed to equal employment opportunities for all team members. Every decision we make regarding employment is solely based on merit, competence, and performance. We are committed to building a team that represents a variety of backgrounds, perspectives, and skills. We realize the full promise of diversity and want you to bring your whole self to work every single day.

Research shows that minority groups typically apply only if they meet 100% of the criteria listed. At Brightside, we are dedicated to fair play and encourage women, people of color, and LGBTQ+ job seekers to apply for positions even if they don’t check every box for the role.

We know that diversity makes for the best problem-solving and creative thinking, and are committed to equity and inclusion. We are dedicated to adding new perspectives to the team and encourage everyone to apply if your experience is close to what we are looking for. We’re an Equal Opportunity Employer and do not discriminate on the basis of race, color, gender, sexual orientation, gender identity or expression, age, religion, disability, national origin, protected veteran status, or any other status protected by applicable federal, state, or local law.

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