Eligibility and Billing Specialist

Join Cartwheel to help tackle the student mental health crisis. Kids spend most of their days in the classroom. And teachers and staff, who play a vital role in their development, are often the first to notice when something is off. But with 1 in 5 young people struggling with mental health, schools are getting crushed by a downward spiral in student crises and staff burnout. With large increases in federal funding for schools and the rise of telehealth, schools are reimagining what mental health support can look like. Cartwheel is an early-stage startup building technology-enabled mental health services that put schools at the center. We see our role as supporting on-campus counselors, psychologists, and school social workers who see kids every day. Instead of going around them, we collaborate with them. This means: Earlier intervention Higher student and family engagement in care Better coordination among the trusted adults in a student’s life Kids shouldn't just aspire to get out of bed and drag themselves to class. They should be able to experience joy. They deserve to envision and build a life they’re excited to live. If you join Cartwheel, you’ll help make this vision a reality for millions of students across the country. We’re backed by top investors including General Catalyst, BoxGroup, and Able Partners, and we're looking for scrappy, mission-driven teammates to join our team. ABOUT THE ROLE We're looking for a team-oriented and mission-driven Eligibility and Billing Specialist to support families throughout their financial journey by verifying insurance eligibility and benefits while providing exceptional billing support and customer service. You will help ensure patients understand their insurance coverage, financial responsibility, and payment options before and after receiving services. This role reports to the Director of Revenue Cycle Management and partners closely with the Health Plan Operations, Care Coordination, and Revenue Cycle teams. Role type: Full-time (40 hours per week) Location: Remote Salary: $55,000 - $70,000 WHAT YOU’LL DO Verify patient eligibility and insurance benefits prior to scheduled appointments, including deductibles, copays, coinsurance, out-of-pocket maximums, and authorization requirements. Document and maintain accurate insurance and eligibility information in the appropriate systems. Research and resolve eligibility, insurance, and billing issues by working directly with insurance carriers, patients, families, and internal teams. Respond to patient and family inquiries regarding insurance coverage, statements, balances, claims, payments, and financial responsibility through phone, email, and other communication channels. Educate families on their insurance benefits, explanation of benefits (EOBs), patient responsibility, and available payment options. Guide patients through payment solutions, including payment plans and financing options such as Klarna, and assist with processing payments and documenting payment arrangements. Serve as a liaison between patients, Care Coordinators, Revenue Cycle, and insurance carriers to ensure accurate information is collected and issues are resolved promptly. Coordinate with internal teams to reschedule or cancel appointments when insurance coverage issues cannot be resolved prior to the visit. Review account activity, claims, payments, and adjustments to research and resolve billing inquiries accurately. Escalate complex eligibility or billing issues to the appropriate internal teams when additional investigation is needed. Deliver compassionate, professional, and timely customer service while handling sensitive financial and insurance-related conversations. Document all patient interactions thoroughly and accurately within internal systems. Identify recurring eligibility or billing trends and recommend process improvements to enhance the patient and family experience. Support other Revenue Cycle functions and special projects as business needs evolve. WHO YOU ARE Must have… Prior experience in eligibility verification, patient billing, customer service, patient access, or revenue cycle management within healthcare, preferably behavioral or mental health. Experience working with commercial and/or Medicaid insurance plans. Strong customer service skills with the ability to explain insurance and billing information in a clear, compassionate manner. Excellent verbal and written communication skills. Strong organizational, problem-solving, and critical thinking skills. Ability to manage multiple priorities in a fast-paced environment. Ability to work independently while collaborating effectively across teams. Passion for supporting the mental health of students and families from diverse communities. Nice to have… Proficiency in Spanish. Experience working with Apero. Experience with patient collections, payment plans, or financial counseling. Experience in pediatric mental health and/or school-based clinical services. Experience working with health insurance carriers in the states where Cartwheel operates. Experience working in a startup or high-growth healthcare environment. Experience working with health insurance carriers in the states in which Cartwheel currently operates (Massachusetts, Illinois, Ohio, New York, Connecticut and/or Rhode Island). The above is a summary of the role, not an exhaustive list. If you think that you have most of the above but not everything, please apply. We'd love to hear from you. WHY YOU’LL LOVE CARTWHEEL Our hope is that Cartwheel will be your best career decision! In addition to tackling one of the biggest challenges of our time, at a company well-positioned to do so, you’ll have: Team-based culture with mission-driven colleagues who will go to bat for you Competitive cash compensation between $55,000 - $70,000 Excellent health insurance Meaningful equity ownership stake Generous paid time off 401K with employer match $500 annual educational stipend Macbook Compensation The base pay range for this role is $55,000 – $70,000 per year. Cartwheel is proud to be an equal opportunity employer. We embrace diverse backgrounds and perspectives and an inclusive work environment. We're committed to equal employment opportunity regardless of race, color, religion, ancestry, national origin, gender, sexual orientation, disability status, or veteran status. We participate in E-Verify. Please be prepared to provide acceptable documentation to verify your identity and work authorization Cartwheel uses AI-assisted tools to support our hiring process. This may include tools that help organize and surface applications for recruiter review, AI-powered candidate communications and scheduling, interview recording and documentation, and an AI chat tool available to candidates during the process. All hiring decisions are made by Cartwheel recruiters and hiring managers. No candidate is selected or eliminated from consideration solely by an automated system. All hiring decisions are made by humans. If you have questions about how AI is used in our process or would like to request an alternative review method, please contact [email protected] Note: Please do not contact our Care, Provider, or Patient Services lines regarding job postings or application status. These teams support our patients and families and are not involved in the hiring process. For all recruitment-related questions, please email [email protected] .