Twin Health - Eligibility Coordinator, Clinical Delivery
Requirements
• 2–4 years of experience in healthcare operations, insurance verification, patient registration, benefits administration, customer support, or a related field; or an equivalent combination of education and experience. • Experience verifying insurance coverage, benefits, eligibility, and authorization requirements. • Strong customer service and member-facing communication skills. • Excellent verbal and written communication skills with the ability to explain complex eligibility and insurance information clearly. • Strong attention to detail and commitment to accuracy. • Ability to prioritize multiple tasks and meet deadlines in a fast-paced environment. • Strong organizational, documentation, and follow-through skills. • Proficiency with Microsoft Office/Google Suite • Ability to work independently while collaborating effectively across teams. • Experience working with healthcare payers, health plans, employer-sponsored benefits, or care management programs. • Familiarity with Salesforce, Zendesk, electronic health record systems, or other healthcare technology platforms. • Experience supporting enrollment or eligibility operations. • Knowledge of healthcare terminology, insurance concepts, and coordination of benefits processes. • Experience documenting workflows and process improvements. • Success Factors • Demonstrates accountability, reliability, and ownership of assigned work. • Maintains a high level of accuracy and quality in all activities. • Approaches challenges with curiosity, critical thinking, and a solutions-oriented mindset. • Adapts quickly to changing priorities and evolving operational needs. • Collaborates effectively and contributes positively to team culture. • Takes pride in delivering exceptional member experiences. • This remote opportunity is available to US based persons located in CST or EST time zones. Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.
Responsibilities
• Eligibility Verification & Coverage Operations • Perform routine and ad hoc insurance verification activities across a variety of commercial and employer-sponsored health plans. • Verify member eligibility, benefits, coverage requirements and coordination of benefits information, communicating through multiple channels (Zendesk, Salesforce, chat) • Review payer requirements and ensure authorizations are obtained prior to member participation in Twin programs. • Investigate and resolve eligibility discrepancies through collaboration with internal teams. • Maintain accurate documentation of eligibility determinations, verification activities, and member communications across multiple systems. • Support ongoing audits and quality assurance initiatives to ensure compliance with established operational standards. • Member Outreach & Support • Conduct outbound and inbound outreach regarding insurance verification, eligibility status, enrollment requirements, and coverage-related inquiries. • Provide clear, professional, and empathetic communication to members regarding eligibility outcomes and next steps. • Address member concerns and escalate complex issues when appropriate to ensure timely resolution. • Support members throughout the enrollment process by removing barriers to activation and participation. • Maintain high standards of member satisfaction through responsive and accurate support. • Conversion Enablement & Operational Support • Support member conversion initiatives by identifying and resolving eligibility-related barriers to enrollment. • Assist with grievance resolution and member retention efforts by coordinating with internal external stakeholders. • Monitor enrollment and eligibility workflows to identify trends, process gaps, and opportunities for operational improvement. • Participate in special projects designed to improve enrollment efficiency and member experience. • Documentation & Process Management • Maintain, and update standard operating procedures (SOPs) and workflows. • Ensure processes remain aligned with changing payer requirements, internal policies, and operational needs. • Identify opportunities for automation, workflow enhancement, and operational scalability. • Cross-Functional Collaboration • Communicate readily with Member Experience, Member Enrollment, Product, Engineering to coordinate eligibility-related activities. • Serve as a resource for eligibility process questions and operational best practices. • Contribute feedback and recommendations to improve workflows, member satisfaction, and operational performance. • Participate in team meetings, training initiatives, and process improvement discussions. • Support reporting and data collection efforts as needed. • Support Zendesk ticketing process • Assist with operational projects and organizational initiatives. • Perform other duties as assigned.
Benefits
• $45,000—$55,000 USD • We have been made aware of fraudulent interview requests being sent using the Twin Health's name. All communications will come from official Twin Health channels and a twinhealth.com email address. We will never ask you to complete a text interview or request financial details during the interview process.
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