Eligibility Coordinator

Position Summary Davis Street is seeking an APP Eligibility Intake Coordinator / Front Office team member to provide patient intake, eligibility verification, appointment support, and insurance coordination. This position interacts with a variety of patients, insurance companies, clinical staff, and external partners to ensure patients are informed of their insurance coverage, co-pays, deductibles, sliding fee eligibility, and other financial responsibilities before services are provided.

Responsibilities

• Perform patient intake, eligibility verification, and documentation for clinic and counseling services.
• Explain insurance coverage, co-pays, deductibles, Sliding Fee eligibility, and other financial responsibilities to patients.
• Complete all required verifications before appointments are scheduled and services are provided.
• Check in patients and schedule or cancel appointments as needed.
• Assist patients with enrollment in local, state, and federal programs.
• Communicate with insurance companies and payer websites to verify eligibility, claims status, referrals, and authorizations.
• Research and resolve eligibility denials, claim rejections, and payer-related issues.
• Maintain accurate patient records, eligibility information, referrals, and authorization documentation.
• Provide weekly intake and referral activity reports to the Claims Supervisor.
• Communicate with patients, staff, providers, insurance companies, and external facilities to provide timely and accurate information.
• Provide excellent customer service to patients and clinical staff regarding insurance coverage and eligibility questions.
• Participate in outreach events, staff trainings, meetings, and other administrative support duties as assigned.
• Maintain confidentiality in accordance with HIPAA.
• Perform other duties as assigned.

Requirements

• High school diploma required; college degree preferred.
• Minimum of 1 year of related experience with insurance coverage, eligibility verification, medical billing guidelines, and payer website navigation.
• Strong understanding of medical terminology.
• Excellent customer service, communication, and interpersonal skills.
• Ability to work with diverse populations in a culturally sensitive manner.
• Detail-oriented, organized, and able to maintain accurate records in a fast-paced environment.
• Strong problem-solving skills and ability to work independently and collaboratively.
• Commitment to the mission and values of Davis Street.
• Bilingual in Spanish preferred.