TPL Specialist

Overview

This is a temporary remote position set to end 2/28/2026. Join a Company That Puts People First—and Wins Awards Doing It!

The primary responsibility of the TPL Specialist is to assist with quality assurance and accuracy of claims review and support of the third party liability (TPL) processes.

• Review and maintain accurate and updated patient information in billing system.
• Conduct direct contact with patient’s health insurance company to verify eligibility.
• Verify services are covered under patients benefit plan.
• Initiate authorization process with the health insurance plan.
• Communicate required documentation needed to complete the authorization process.
• Timely and consistent follow up with locations for requested information.
• Confirm any secondary policies and apply same process regarding eligibility, benefits and authorization requirements.
• Forecast and communicate potential billing and A/R challenges or concerns to the Billing and A/R managers.
• Conduct an accurate review of received documents to determine specific requirements are met for compliance.
• Calculate benefits based on each individual policy or plan with strong attention to detail and accuracy.
• Manage detailed information related to Home and Local plans as well as HMO and PPO policies.

• High school diploma or GED.
• Proven ability to analyze complex process errors and identify root cause corrections.

• Healthcare and insurance payer knowledge/experience is preferred.
• Professional coding certifications strongly preferred.

• Must be able to adhere to confidentiality standards and professional boundaries at all times.
• Attention to detail.
• Time management.
• Ability to remain calm and professional in stressful situations.
• Strong commitment to excellence.
• Quick-thinking and astute decision making skills.
• Effective problem-solving and conflict resolution.
• Excellent organization and communication skills.

Must be able to speak, write, read and understand English; occasional lifting, carrying, pushing and pulling of 25 pounds; prolonged walking, sitting, standing, bending, kneeling, reaching, twisting; must be able to sit and climb stairs; must have visual and hearing acuity; must have strong sense of smell and touch.

Performs duties in an office environment during agency operating hours. Must be able to function in a wide variety of environments which may involve exposure to allergens and other various conditions.

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Headhunters and recruitment agencies may not submit resumes/CVs through this website or directly to managers. Aveanna does not accept unsolicited headhunter and agency resumes, and will not pay fees to any third-party agency or company that does not have a signed agreement with Aveanna.

Entry level

Full-time

Other

Hospitals and Health Care