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
Schedule:
- Fixed shift
- Monday to Friday
- Night shift
Experience:
- Verification & Authorization: 1 year (Preferred)
Work Location: In person
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