Eligibility Specialist

St. Hope Foundation (Houston)

Sugar Land, TX, USA

Full time

Healthcare / Community Health & Mental Health

Sep 14

This job is no longer accepting applications.

We are seeking a ELIGIBILITY SPECIALIST to become a part of our team! You will be responsible for processing insurance claims for healthcare facilities.



  • Consistently follow up on unpaid claims utilizing monthly aging reports
  • Filing appeals when appropriate to obtain maximum reimbursement
  • Establish and maintain strong relationships with providers, clients, patients, and staff.
  • Data entry of all patient demographic, guarantor and insurance information, posting procedures and insurance/patient payments, balance to daily deposits.
  • Accurately Post all insurance payments by line item.
  • Timely follow up on insurance claim denials, exceptions or exclusions.
  • Reading and interpreting insurance explanation of benefits.
  • Provide additional information as requested by insurance companies
  • Demonstrate flexibility, enthusiasm and willingness to cooperate while working with others in inter-professional care teams with activities to include participating in daily huddles



  • High School diploma or equivalent.
  • Medical Billing and Coding certificate or at least two years of medical billing and coding experience.
  • Experience in CPT and ICD-10 coding; familiarity with medical terminology
  • Good keyboard skills - 35 wpm
  • Ability to work with frequent interruptions and maintain emotional control under stress
  • Detailed oriented and organized
  • Great customer service and communication skills


Working Conditions

  • The position occasionally requires sitting, standing and bending. Occasional very light lifting, up to 20 pounds or an equivalent weight may be required


Employment Benefits:

  • Paid Time Off Plan, Comprehensive Medical/Dental/Vision, Life Insurance, 401k (6% Match), Paid Federal Holidays

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St. Hope Foundation (Houston)

Providing medical care, dental care and prevention services to Persons Living With HIV/AIDS in Houston, Conroe & Stafford Texas