Source Job

$44,000–$52,000/yr
US

  • Review patient records and clinical documentation to determine eligibility accurately.
  • Communicate with patients, clinicians, and providers to ensure a smooth onboarding process.
  • Maintain records in EMR systems and manage multiple cases simultaneously.

EMR Systems HIPAA Compliance Patient Communication Organizational Skills

20 jobs similar to Eligibility Specialist

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$44,000–$52,000/yr
US

  • Eligibility Review: Review patient records and clinical documentation to determine eligibility for Form Health.
  • Record Collection: Manage requesting, faxing, and tracking medical records from external providers while ensuring HIPAA compliance.
  • File Communication: Maintain clear communication with patients and colleagues to keep them updated throughout the eligibility process.

Form Health is a virtual obesity medicine clinic that provides multi-disciplinary evidence-based obesity treatment through telemedicine. Founded in 2019, it is a venture-backed startup with an experienced clinical and leadership team, committed to a culture of inclusion and patient-first values.

US Unlimited PTO 16w maternity 8w paternity

  • Support member onboarding and care coordination in a remote healthcare environment.
  • Maintain accurate health records and assist with clinical and administrative tasks.
  • Collaborate with care teams to improve patient outcomes and operational workflows.

The partner company is a technology-driven healthcare organization focused on improving chronic disease outcomes. It operates with a collaborative global team and offers opportunities for professional growth.

US

  • Manage medical records workflows and coordinate outgoing referrals to ensure timely, accurate, and compliant patient care.
  • Oversee Release of Information (ROI) processes, track records, and coordinate specialty referrals within the EMR.
  • Support providers and clinical teams by maintaining organized, efficient workflows that promote continuity of care and HIPAA compliance.

Herself Health is building a new model of primary care for women 65+ to address rushed appointments and generalized care. With a team of 100+ colleagues, they foster a culture of collaboration, excellence, and a customer-first mindset.

US

  • Engage patients and help them navigate their care, improving communication with their medical practice.
  • Accurately document patients' medical history and issues in the electronic health record.
  • Utilize effective communication modalities to engage and schedule high-risk patients.

Guidehealth is a data-powered healthcare company using AI to make healthcare affordable and improve patient outcomes. They are a physician-led, remote-first company with a culture focused on accountability, growth, collaboration, and empathy.

US 4w PTO

  • Process medical records requests accurately and within required turnaround timelines.
  • Manage incoming payer communications and support billing operations, including refunds and claim-related activities.
  • Collaborate with internal teams to improve workflows and ensure compliance with healthcare requirements.

Our partner company is a mission-driven organization focused on improving access to quality care. They are a growing organization that values operational excellence and patient experiences.

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  • Process medical record requests accurately and efficiently according to established procedures.
  • Manage incoming requests through multiple channels and ensure timely completion within required service timelines.
  • Respond to patient questions and requests through phone communication with professionalism and empathy.

Our partner supports the healthcare ecosystem by helping patients, providers, and organizations access critical medical information efficiently and securely. They offer a supportive, mission-driven environment with opportunities for growth and development.

$18–$21/hr
US

  • Support clinicians with patient coordination tasks including pharmacy communication, referrals, and scheduling.
  • Provide empathetic, patient-centered communication and document tasks accurately in the electronic health record.
  • Ensure compliance with HIPAA and confidentiality standards while participating in team huddles and quality initiatives.

Curai is a healthcare company that harnesses artificial intelligence and clinical expertise to make high-quality primary care more affordable, accessible, and effective. They are a mission-driven, remote team committed to diversity and inclusion.

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  • Assist patients with connecting to telehealth video visits and troubleshooting technical issues.
  • Guide patients through the virtual intake process, collecting vital signs, medical history, and medication reconciliation.
  • Handle inbound calls, assess patient needs, and escalate clinical concerns to Registered Nurses as needed.

Everlywell is a digital health company that leverages AI to deliver personalized health insights through at-home testing and virtual care. They have provided nearly one billion health insights to over 60 million people and are the leading at-home testing company in the US, fostering a culture of innovation and scale.

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  • Make outbound calls to patients to complete intake calls and manage scheduling.
  • Handle medical records, data entry, and documentation in EHR systems, triaging messages.
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Salvo Health is a new approach to helping millions of Americans facing chronic gut health and metabolic conditions, providing continuous, app-based care with remote patient monitoring. The company is backed by leading healthcare investors and offers a remote work environment, flexible time-off, and a culture driven by constant innovation and empathy.

US

  • Provide administrative support to clinical staff in a healthcare office environment, primarily via video conference.
  • Handle incoming calls, patient records, correspondence with providers, and scheduling of home visits.
  • Ensure coordination of care and smooth day-to-day office operations, including insurance authorizations and supply ordering.

Vynca provides comprehensive care for individuals with complex needs to have more quality days at home. The company is a close-knit community with core values of Excellence, Compassion, Curiosity, and Integrity.

$16–$22/hr
US

  • Act as primary contact for assigned healthcare facilities, managing medical record requests and ensuring HIPAA compliance.
  • Verify patient information and process records accurately while maintaining confidentiality and adhering to policies.
  • Provide exceptional customer service, handle high call volumes, and meet production and quality goals.

MediCopy provides medical records management and compliance services for healthcare facilities. The company emphasizes a professional and customer-oriented culture, with a focus on accuracy and privacy.

US

  • Review and complete disability and leave documentation for patients.
  • Communicate with healthcare providers to gather required medical information.
  • Ensure compliance with HIPAA and manage multiple cases independently.

The company provides innovative healthcare technology solutions that streamline patient documentation. It operates remotely with a focus on accuracy, service, and operational excellence, though team size is not specified.

United States

  • Receive, review, and process requests for patient health information according to established policies and HIPAA regulations.
  • Respond to inbound and outbound calls from patients, insurance companies, and attorneys regarding medical record status.
  • Maintain accurate documentation across multiple platforms and electronic health record systems, ensuring data accuracy and privacy.

This partner company provides healthcare information management services, focusing on processing medical record requests and ensuring patient privacy. They offer a structured, high-volume environment with training, mentorship, and dedicated tools for temporary employees.

$16–$22/yr
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  • Determines records to be released by reviewing requestor information in accordance with HIPAA guidelines.
  • Logs medical record requests into ROI On-Line database and scans records.
  • Answers phone calls and responds to walk-in customers regarding medical records.

MRO provides release of information (ROI) services for medical records. They have employees at client facilities throughout the United States and pride themselves on a positive work environment.

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  • Conduct outbound calls to pharmacies to support patient care initiatives and address medication-related cases.
  • Communicate professionally with pharmacy staff and clinical teams to resolve issues and gather information.
  • Maintain accurate documentation and records within internal software platforms to ensure compliance.

The partner company is a fast-growing healthcare technology organization that connects patients, providers, and pharmacies to improve healthcare outcomes. It has a mission-driven and supportive team culture, focusing on improving patient care through innovative technology.

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  • Perform medical claims audit reviews with a focus on the Home Health sector, applying medical review guidelines and documenting findings.
  • Collaborate with the audit team to identify vulnerabilities, generate audit letters, and support findings during appeals.
  • Maintain knowledge of coding systems (ICD-10, CPT-4, HCPCS) and regulatory changes to ensure high-quality, deadline-driven work.

Machinify is a leading healthcare intelligence company that delivers value, transparency, and efficiency to health plan clients using an AI-powered platform. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, the company fosters a collaborative, fast-paced remote culture.

US

  • Lead all medical records and release of information operations, ensuring compliance with HIPAA and state regulations.
  • Design and implement scalable HIM workflows, policies, and tracking systems to improve efficiency and accuracy.
  • Partner with Compliance, Legal, Clinical Operations, Technology, and Quality teams to support organizational growth.

Backpack Healthcare transforms access to behavioral healthcare for children, adolescents, and families. As a fast-growing company expanding across multiple states, we focus on building scalable systems and fostering a collaborative, mission-driven culture.

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  • Serve as a critical gateway to patient care by ensuring timely and accurate processing of medical referrals.
  • Collaborate with providers and clinical teams to review, prioritize, and route referrals in a fully remote setting.
  • Apply administrative expertise and medical knowledge to support patient safety and operational excellence.

The company is a leading academic healthcare organization dedicated to patient care, research, and education. It offers a fully remote, inclusive work environment with opportunities for career growth.

$34–$38/hr
US 3w PTO

  • Perform daily audits on client data for completeness and accuracy of coding using clinical knowledge.
  • Respond to provider appeals and meet client turnaround time and KPI goals.
  • Utilize coding validation training to become familiar with claims payment policies and regulations.

Cotiviti is a healthcare analytics company that uses data-driven solutions to improve payment accuracy and quality in healthcare. The company offers a competitive benefits package and fosters a collaborative, fast-paced work environment.

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  • Conduct Annual Wellness Visit questionnaires over the phone with patients.
  • Make outbound calls to schedule and complete screenings.
  • Accurately document patient information in EMR systems like NextGen.

Welltality provides healthcare support by conducting Medicare Annual Wellness Visit pre-screenings to help patients stay proactive with their care. The team values accountability, teamwork, and continuous improvement.