Healthcare Insurance Specialist

About the Role

We are seeking a Healthcare Insurance Specialist with a strong background in eligibility verification, claims processing, and enrollment management. This role will involve working closely with patients, insurance carriers and internal teams to ensure smooth and accurate insurance workflows.

The ideal candidate is detail-oriented, well-versed in healthcare insurance protocols, and confident in navigating complex benefits, coverage issues, and claims follow-ups.

Key Responsibilities

• Verify patient eligibility and benefits with major insurance providers, with a focus on Aetna
• Process and follow up on medical claims, ensuring accuracy and compliance with payer requirements
• Manage enrollment workflows including updates and corrections
• Address claim denials and submit necessary appeals or adjustments
• Communicate with patients and insurers regarding coverage status, documentation, and billing questions
• Maintain up-to-date knowledge of payer-specific policies and healthcare regulations
• Ensure all records are accurate and comply with HIPAA and company standards
• Assist with reporting and audit preparation as needed

Qualifications

• At least 2 years of experience in healthcare insurance or medical billing roles
• Strong understanding of benefits eligibility, claims processing, and insurance billing practices
• Familiarity with insurance workflows is strongly preferred
• Excellent attention to detail and accuracy in documentation and system entry
• Strong communication skills for both patient interaction and internal collaboration
• Ability to work independently and manage time effectively in a remote setting
• Familiarity with HIPAA regulations and healthcare data privacy

This is a 100% Remote wok

Full time

Night shift

$5/hr. Rate will increase to $6/hr after training