Job Details

Eligibility Specialist

The Eligibility Specialist is responsible for contacting insurance companies to verify a patient's coverage and eligibility for home healthcare services, ensuring accurate billing by confirming details like benefits, copay amounts, and service limitations, all while adhering to HIPAA regulations and company policies; this role typically involves utilizing dedicated software to manage patient information and insurance verification processes.

This role is a remote hybrid position where you will work from home but are required to come into the office for any required trainings or in-person meetings.

Schedule: Full-Time hours Wednesday through Sunday 10:00am-6:00pm EST supporting the East Region Home Health Team.

Essential Job Functions

• Contacting insurance companies:
• Calling insurance providers to verify patient eligibility and coverage for requested home healthcare services.
• Data entry:
• Accurately entering patient and insurance information into the company database.
• Benefit verification:
• Confirming details like copay amounts, deductibles, and service limitations for each patient's insurance plan.
• Eligibility checks:
• Assessing if a patient meets the criteria for covered home healthcare services based on their medical diagnosis and insurance policy.
• Prior authorization requests:
• Initiating prior authorization requests for specific treatments or services when necessary.
• Patient communication:
• Explaining verification process to patients and addressing any questions regarding their insurance coverage.
• Claims submission support:
• Providing accurate patient and insurance information to the billing department to facilitate smooth claims submission.
• Compliance with regulations:
• Adhering to HIPAA guidelines to protect patient privacy.

Requirements: High school diploma, 2+ years of related experience, strong computer skills (Word, Excel, Power Point). Preferences: Bachelor's Degree, HCHB experience.

Comprehensive Benefits (Full-time positions): Aveanna offers benefits designed to support you inside and outside of work, including:

• Competitive pay
• Medical, Dental, Vision, and Life insurance
• Voluntary Pet Insurance for your fur babies
• 401(k) with Company match
• Vacation time, Sick time, Paid Holidays, and Floating Holidays
• Tuition reimbursement and tuition discounts
• Free continuing education units (CEUs) for nurses
• Employee Assistance Program and Employee Relief Fund
• Employee Stock Purchase Plan

Our mission is to revolutionize the way homecare is delivered, one patient at a time. We are committed to innovation, clinical excellence, and compassionate care—because outcomes improve when care is personal. Join the revolution and make a meaningful difference in the lives of patients and families every day.

Remote and hybrid work is limited to the United States only, and in states where Aveanna conducts business. Remote workers should be prepared to come into the office periodically.