Eligibility Specialist

Job Description

Grow Therapy, a company focused on improving mental healthcare accessibility, is seeking an experienced Eligibility Specialist. The Eligibility Specialist will be responsible for all aspects of eligibility processes to ensure client coverage is verified prior to care. The role involves streamlining eligibility workflows, identifying opportunities for improved processes, and ensuring care is covered prior to service. The Eligibility Specialist will report to a Team Lead and work closely with Customer Support teams to assist with provider or client questions related to eligibility.

• Utilize clearinghouses and payer portals to verify patient eligibility and benefits.
• Investigate and resolve eligibility-related denials.
• Complete outbound calls to insurance carrier representatives.
• Resubmit claims with errors.
• Draft appeals for claim denials.
• Ensure patient data in software is correct and up to date.
• Prioritize workflows based on age of claims.

• Strong understanding of healthcare claims, plan benefits, and patient responsibilities.
• At least 2 years of experience in Medical Billing or Healthcare setting.
• Process-Driven and Adaptable.
• Team Player.

• Comprehensive health insurance plans, including dental and vision
• Flexible working hours
• Flexible Time Off
• Company-wide winter break
• Mental health mornings (2 hours each week)
• Wellness Stipend
• In-office meals and snacks
• Continuous learning opportunities
• Competitive salary