Eligibility Specialist

Job Title: Eligibility Specialist

About Us

At West Cancer Center, we are dedicated to providing compassionate, patient-centered care while advancing groundbreaking research. Our team fosters collaboration, innovation, and professional growth, ensuring that every role contributes to making a difference in patients’ lives. Join us in our mission to provide comprehensive support to those navigating the challenges of cancer treatment.

Position Overview

The Eligibility Specialist ensures that all patient insurance and referral information is accurate, current, and correctly entered in the system. This role is responsible for verifying benefits, resolving claim issues, and supporting patients with benefit-related questions, working collaboratively with internal teams to ensure a seamless patient experience.

Key Responsibilities

• Verify insurance benefits for new patients, add-ons, and hospital surgeries
• Verify benefits on existing patients and update records as needed
• Enter and validate patient demographics and insurance in Practice Management (PM) and EMR systems
• Enter and verify copayments and financial information
• Contact primary care physicians or patients to obtain referrals
• Handle patient inquiries regarding insurance coverage and benefits
• Assist in explaining financial screening and application processes, collaborating with Financial Advocates
• Work closely with West Cancer Foundation for screening and approvals
• Assist patients who are uninsured in connecting with appropriate financial support teams
• Manage STAT add-on list daily
• Review and process scanned insurance cards and maintain accurate documentation
• Monitor group inbox tasks in EMR for eligibility and referral issues
• Communicate effectively with patients to explain coverage, copays, deductibles, out-of-pocket expenses, and referral requirements
• Collaborate with Front Desk, Medical Records, Business Office, Radiology, Nursing, and other internal teams to ensure accurate and timely insurance verification
• Address eligibility and referral issues raised by staff and leadership in a timely manner
• Perform all other duties as assigned
• Some travel to satellite offices may be required

Qualifications

Education & Experience

• High school diploma or GED required
• Minimum of 2–3 years of experience in insurance verification in a medical environment
• Data entry skills required; proficiency in 10-key by touch

Skills & Abilities

• Strong organizational and follow-up skills
• Excellent written and verbal communication skills
• Strong customer service and interpersonal skills
• Ability to analyze situations and resolve issues quickly and accurately
• Ability to prioritize and handle multiple tasks in a fast-paced environment
• Ability to collaborate effectively across multiple teams
• Proficiency in computer applications, including EMR, PM systems, Microsoft Office, Outlook, and web portals
• Knowledge of insurance verification, patient eligibility, referrals, and healthcare billing processes

Why West Cancer Center is a Great Place to Work

• Meaningful Impact: Play a direct role in supporting patients through one of the most challenging times of their lives.
• Collaborative Culture: Work alongside a multidisciplinary team of dedicated professionals committed to improving cancer care.
• Professional Development: Benefit from ongoing training, educational resources, and growth opportunities.
• Mission-Driven Environment: Be part of an organization guided by compassion, integrity, and innovation.

No nights, weekends, or holidays. Comprehensive benefits package.

Join Us

If you’re detail-oriented and passionate about helping patients navigate their healthcare coverage with ease and transparency, apply today to join West Cancer Center as an Eligibility Specialist.