Eligibility Verification Specialist

hace 22 horas


Monterrey, Nuevo León, México Gini Talent A tiempo completo

Eligibility Verification Specialist (Hybrid)

Location:
Monterrey

Type:
Full-time (Hybrid)

About the Role

We are looking for an
Eligibility Verification Specialist
to join our growing operations team. In this role, you will ensure that patient insurance information is accurate and up to date for upcoming appointments. You will verify eligibility, document findings with precision, and communicate with patients when follow-up is required.

This is a detail-oriented, high-volume role that requires strong organizational skills, excellent documentation abilities, and customer service awareness.

Key Responsibilities

  • Verify insurance eligibility using the Pediatric Associates Eligibility Verification Quality Checklist.
  • Review upcoming appointments and determine eligibility requirements based on each patient's health plan.
  • Use all available tools (internal systems, web portals, phone) to confirm insurance status.
  • Update patient insurance details with accuracy and completeness.
  • Identify eligibility issues and communicate them to patients or parents; document all actions taken.
  • Complete assigned eligibility reviews within the required timeframe.
  • Coordinate with clinic staff via email, Microsoft Teams, and phone as needed.
  • Escalate issues to the supervisor when appropriate.
  • Meet established productivity and quality standards.

Qualifications

  • High School Diploma or equivalent required.
  • 1–2 years of experience in insurance verification, healthcare operations, or a similar administrative role preferred.
  • Strong attention to detail and ability to manage high-volume tasks across multiple systems.
  • Excellent documentation skills.
  • Strong communication skills via email and phone.
  • Ability to sit for extended periods; occasional lifting of up to 25 lbs may be required.
  • Proficiency with computers; ability to type at least 35 WPM.

Why Join Us?

  • Work in a professional and supportive environment.
  • Contribute directly to smoother clinic operations and improved patient care.
  • Develop skills in healthcare administration and insurance processes.
  • Be part of a collaborative and mission-driven operations team.

How to Apply

  • If you meet the qualifications and are based in Monterrey, please submit your application directly via LinkedIn.


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