Eligibility and Benefits Specialist

Obtain referrals from primary care providers and referring physicians, ensuring all referral requirements are met prior to scheduling or treatment.

Track referral status and proactively follow up with provider offices, payers, and patients to ensure referrals are received and remain valid.

Communicate insurance coverage, patient financial responsibility, estimated out-of-pocket costs, and Oshi's billing model in a clear, professional, and empathetic manner.

Research and resolve eligibility, coverage, referral, and insurance discrepancies that may impact patient care or reimbursement.

Monitor eligibility verification queues, insurance changes, pending requests, and coverage updates to ensure timely resolution.

2+ years of healthcare revenue cycle experience with a focus on eligibility, benefits, insurance verification, or patient access.

Reports To:

Lead Revenue Cycle

Locations Hiring From:

Arizona, Delaware, Florida, Georgia, Idaho, Indiana, Louisiana, Missouri, New Hampshire, North Carolina, South Carolina, Tennessee, Texas, Vermont, Virginia ONLY.

Must currently reside and plan on residing in the entire employment.

Schedule:

As an Eligibility & Benefits Specialist, you will be responsible for or verifying patient insurance eligibility and benefits, obtaining required referrals, communicating coverage and financial responsibility, and supporting accurate patient access and reimbursement.

This role helps ensure patients understand their insurance benefits, estimated costs, and referral requirements while proactively identifying and resolving coverage issues before services are rendered.

You will work closely with our Revenue Cycle Leads, other members of the Revenue Cycle team, and payer partners to improve the patient financial experience, reduce claim denials, and support efficient revenue cycle operations.

Your attention to detail, excellent organizational skills, and commitment to customer access will contribute to the financial stability and success of Oshi as we pioneer the way in GI care.

Oshi Health is a virtual digestive health practice on a mission to transform GI care. We combine compassionate, multidisciplinary care with innovative technology to help people with chronic digestive conditions get the answers and relief they deserve. When you join Oshi, you're joining a team and a mission that's changing what great healthcare looks like. Oshi Health is revolutionizing GI care with a digital clinic model that provides easy, convenient access to an integrated and multidisciplinary care team that takes a whole-person approach to diagnosing, managing, and treating digestive health conditions. We take time to get to know each patient, develop a personalized, whole-person care plan that includes identification of symptom triggers and prescription of evidence-based interventions, including medications, dietary changes, and mental health support.