Healthcare Insurance Eligibility Representative Remote
: Job Details :


Healthcare Insurance Eligibility Representative Remote

Imagenet

Job Location : Scranton,PA, USA

Posted on : 2025-09-11T06:20:40Z

Job Description :

About the Role: We are seeking a detail-oriented Insurance Verification Specialist to join our call center team. This role is essential in verifying insurance eligibility and benefits prior to patient services, ensuring accurate data entry and a smooth experience for both patients and internal teams. The ideal candidate thrives in a fast-paced, high-volume environment and delivers excellent customer service over the phone. Job Type: Full-time - 100% Remote Position Schedule: Monday -Friday 11:00am to 8:00pm EST/10:00am to 7:00pm CT / 9:00am to 6:00pm MT Pay: $16.00 - $18.00 per hour DOE What We Offer:

  • Paid training period
  • Medical, Dental, Life, Vision, HSA, 401K
  • 7 Paid Holidays with no wait to qualify
  • 6 PTO days per year
  • Equipment provided
Key Responsibility:
  • Verify insurance eligibility and benefits using payer portals, phone calls, and verification tools
  • Update and maintain patient demographic and insurance data in the Electronic Health Record (EHR) system
  • Document key benefit details including copayments, deductibles, coinsurance, and out-of-pocket maximums
  • Communicate with patients to clarify insurance coverage and respond to basic inquiries
  • Collaborate with clinical and billing teams regarding eligibility and authorization status
  • Identify and resolve discrepancies in insurance information; escalate complex cases as needed
  • Maintain compliance with HIPAA and patient privacy regulations
  • Verify insurance eligibility and benefits using payer portals, phone calls, and verification tools
  • Update and maintain patient demographic and insurance data in the Electronic Health Record (EHR) system
  • Update and maintain patient demographic and insurance data in internal systems
  • Document benefit details: copayments, deductibles, coinsurance, out-of-pocket maximums
  • Communicate clearly and professionally with patients regarding coverage
  • Collaborate with internal teams to resolve discrepancies and escalate complex cases
  • Ensure compliance with HIPAA and privacy regulations
Requirements:
  • 1-2 years of experience in a healthcare call center or healthcare administration (insurance verification, patient registration, or medical billing)
  • Familiarity with health insurance terminology: copay, deductible, coinsurance, HMO, PPO, subscriber
  • Basic understanding of government-sponsored plans (Medicaid and Medicare) and their differences
  • Proficient in navigating healthcare systems; experience with EHRs preferred
  • Demonstrated excellence in customer service and client interaction
  • Clear and professional communication skills
  • Must successfully pass a criminal background check
Preferred Experience:
  • Experience in high-volume healthcare settings (e.g., specialty practices, call center)
  • Familiarity with major insurance payers
  • Strong adherence to daily schedules, tasks, and performance metrics
  • Ability to multitask effectively while maintaining high attention to detail
  • Self-motivated, well-organized, and skilled in time management and problem-solving
  • Capable of working independently and collaboratively within a team environment
***WORK FROM HOME REQUIREMENTS***
  • High Speed Internet of 25MBPS download and 5MBPS upload. You will be required to provide a speed test.
  • Ability to directly hardwire to your modem
  • Required to have a quiet dedicated work area.
COMPANY OVERVIEW: Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans' members and providers. The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans' members and providers. The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually. The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients. Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines. Imagenet LLC provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
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