Eligibility Verification & Authorization

Job Summary: The Eligibility Verification & Authorization Specialist is responsible for verifying patient insurance coverage, determining eligibility for services, and securing prior authorizations and referrals as required by insurance carriers. This role plays a vital part in ensuring patients receive timely care and that services are reimbursed accurately by payers.

Key Responsibilities:

• Verify patient insurance coverage and eligibility via online payer portals or by contacting insurance carriers directly.
• Obtain prior authorizations for procedures, and specialist visits as required.
• Proactively follow up with insurance companies on pending authorizations and denials.
• Maintain knowledge of payer-specific guidelines, medical necessity requirements, and authorization procedures.
• Work closely with the billing team to ensure accurate claim submission and reduce denials.
• Ensure compliance with HIPAA and other applicable regulations in all communications.

Job Types: Full-time, Permanent

Pay: ₹21,000.00 - ₹35,000.00 per month

Benefits:

• Commuter assistance
• Food provided

Experience:

• Verification & Authorization: 2 years (Preferred)

Work Location: In person