Job Title: Commercial Insurance Eligibility Representative Mon-Fri 8am-5pm Must be in Mass or NH. Remote
Position Summary
We are seeking a detail-oriented and knowledgeable Commercial Insurance Eligibility Representative to join our team. This role is crucial for ensuring that we identify a patients health insurance coverage at the time of their accidents, which will help streamline the claims process. This includes checking for active coverage and understanding policy details. The ideal candidate will have a solid understanding of commercial insurance plans, with additional knowledge of Medicare and Medicaid plans considered a significant advantage. Familiarity with health billing systems such as Epic, Meditech, or Athena is also highly desirable.

Key Responsibilities:

Verify patients’ insurance coverage for commercial health insurance plans and confirm active status at the time of the accident.
Review and interpret insurance policy documents, benefits, and coverage details.
Utilize various tools and databases to check insurance eligibility and benefits.
- NEHEN/TriZetto
- Passport
- MaxRTE

Qualifications:

Strong understanding of commercial health insurance plans; knowledge of Medicare and Medicaid plans is a plus.
Experience with health billing systems like Epic, Meditech, or Athena preferred
Experience with Microsoft Office
Strong communication skills
Detail-oriented with strong organizational and analytical skills.
Ability to work independently and as part of a team in a fast-paced environment.

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Insurance Eligibility Representative

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