Member Financial Services Specialist at Eleanor Health in Remote

About the Role

The ideal candidate for this position  is a proactive self-starter who demonstrates critical and creative thinking to resolve issues effectively, performs well with limited reliance on detailed workflows, and adapts quickly as priorities or processes evolve. This role requires the ability to work efficiently under pressure, conduct thorough independent research, determine appropriate courses of action, and leverage multiple tools to support accurate, timely decision-making. This position works collaboratively with the RCM team and cross-functional departments to complete financial clearance, manage member balances, and resolve member-facing claims issues, including coordination of benefits (COB). A strong understanding of claim details and COB resolution is highly valued, and experience with third-party liability (TPL) is preferred. The candidate will also work proactively to reduce bad debt and ensure timely resolution of outstanding balances.  The selected candidate must maintain strong focus and engagement with minimal distraction, demonstrate excellent attendance and punctuality, and exhibit exceptional attention to detail. Success in this role requires strong information retention, the ability to recall and apply policies, procedures, and recent updates in real time, and effective conflict de-escalation and negotiation skills. Additionally, the candidate must be capable of professionally communicating benefit interruptions or eligibility determinations to community members with clarity, empathy, and confidence.

What You'll Do

• Act as financial counselor to community members by explaining their benefits and financial responsibility in a clear, concise manner
• Set appropriate expectations with community members regarding Eleanor Health policies for payment
• Handle communication effectively and demonstrate empathy with all community members
• Resolve community member issues and questions related to their outstanding balance and insurance coverage; ensure plan for payment is established, documented, and upheld
• Demonstrates strong expertise in managing the complexities of financial clearance, with confidence in assisting members across multiple communication channels, including phone, secure messaging, and email. 
• Comfortable engaging with diverse and often complex populations, consistently exhibiting patience, sound judgment, and strong problem-solving abilities. 
• Committed to delivering high-quality service and a positive member experience in every interaction.
• Assess current workflows and surface opportunities to drive efficiency and improve performance against key metrics
• Collect outstanding community member balances
• Collaborate and communicate with RCM, Clinic, and Access teams to ensure shared understanding of opportunities to enhance processes and barriers to success
• Utilize data to inform prioritization of work
• Research and respond to insurance denials
• Review insurance remittances for rejections and respond with corrective action
• Fax, scan or email correspondence to patients
• Attend weekly team meetings and monthly staff meetings
• Assist in training new team members when appropriate
• Perform other duties as assigned by manager

Qualifications

• Minimum of 3 years’ experience working in a healthcare customer service role, with focus on resolving financial issues while providing high quality customer experience
• Strong communication skills
• Ability to work in a busy, high-volume environment
• Knowledge of billing and collection practices required
• Experience with claims follow up, processing patient payments, reading and understanding insurance correspondence and EOBs
• The ability to work in a fast-paced and sometimes ambiguous environment

Preferred:

• Behavioral Health and substance use disorder experience preferred
• Experience with value-based care or alternative payment models preferred 
• Athena experience preferred

Compensation & Benefits

The total target compensation range for this position is $21-23 an hour. The actual compensation offered depends on a variety of factors, which may include, as applicable, the applicant’s qualifications for the position; years of relevant experience; specific and unique skills; level of education attained; certifications or other professional licenses held; other legitimate, non-discriminatory business factors specific to the position; and the geographic location in which the applicant lives and/or from which they will perform the job.

Eleanor Health offers a generous benefits package to full-time employees, which includes:

• Generous Paid Time Off (prorated for new employees) - unplug, relax, and recharge! 
• • 12 Vacation days
  • 12 Wellness (Sick) days
  • 3 Floating holidays
  • 9 Company-observed holidays
  • Jury Duty, Voting Leave, and other forms of paid time off may be available
• Eleanor-paid medical and dental insurance plans, with affordable vision coverage - We are a health first company, and we strive to make our plans affordable and accessible.
• 401(k) plan with 3% match - We are excited to be able to support the long-term financial well-being of our team in a way that reinforces Eleanor’s commitment to equity.
• Short-term disability - We understand that things happen, we want you to feel comfortable to take time to get better.
• Long Term Disability - Picks up where Short Term Disability leaves off (employee paid).
• Life Insurance - Both Eleanor and employee-paid options are available.
• Family Medical Leave - Eleanor Health’s Paid Family & Medical Leave (“PFML”) is designed to provide flexibility and financial peace of mind for approved family and medical reasons such as the birth, adoption, or fostering of a child, and for serious health conditions that you or a family member/significant other might be facing.
• Wellness Perks & Benefits - Mental Health is important to us and we want our employees to have the accessibility you deserve to talk things through, zen with a mindfulness app, or seek assistance from health advocates
• • Mindfulness App Reimbursement
  • EAP with eight face-to-face sessions
  • Virtual health and wellness visits covered by our medical plan.