Eligibility, Benefits and Prior Authorization Specialist

6 days ago

Karachi, Sindh, Pakistan Premier MBC Full time $70,000 - $120,000 per year

Work shift: Night shift from 6 pm to 3 am

Work Location: Shahrah e Faisal, Karachi

Education: Bachelors

Experience: 1+ years in Eligibility, Benefits, and Prior Authorization under any Medical Billing company.

Benefits:

Dinner, OPD 8%, EOBI, PF 8% and Saturday/Sunday off.

Job Description:

Verification of Insurance Information (Provided by Practice Front Office / Client):

Provide Verified insurance information.

Use the patient's insurance card to gather necessary details like insurance company name, policy number, group number, and subscriber information with procedure Details

Insurance Eligibility Check:

· Utilize an eligibility verification system or software provided by insurance companies or third-party vendors.

· Input the patient's insurance information into the system.

User Should Collect:

Verify the patient's coverage details, including:

· Coverage status (active/inactive)

· Effective date of coverage

· Coverage type (e.g., HMO, PPO)

· Co-payments, deductibles, and coinsurance amounts

User Should add Data in Spreadsheet:

Ø Patient Name (Last, First)

Ø DOB

Ø Provider Name

Ø Network Status

Ø Auth Req Y/N

Ø If required, Escalate and ref Case #. In notes.

Ø Referral Req Y/N

Ø Ded Amount

Ø Ded Remaining

Ø Co-insurance

Ø Out of Pocket Remaining

Ø Pri. Ins

Ø Eff Date

User should Collect from Practice Management:

Ø Self-Pay (NP) - Y/N

Ø Self-Pay (Est) - Y/N

Ø Previous Patient Balance

Ø Insurance Balance

Ø Balance to Collect

Ø Notes

Coverage limits or restrictions

· Ensure the system provides real-time information whenever possible.

Verification Review and Resolution:

· Review the eligibility results thoroughly for accuracy and completeness.

· Resolve any discrepancies or issues identified during the verification process from Availity & PM

· Contact the patient or insurance company for clarification if needed.

Documentation:

· Document the results of the eligibility verification process in the patient's EHR.

· Include details such as the date of verification, verification status, and any notes regarding discrepancies or follow-up actions.

Job Type: Full-time

Application Question(s):

  • Do you have a bachelor's Degree?
  • Can you speak English fluently?
  • How much experience do you have in Eligibility, Prior Authorization and Benefits?
  • Please mention you current and expected salary in USD?

Work Location: In person

  • Prior Authorization Specialist

    1 week ago

    Karachi, Sindh, Pakistan Cognizance Solutions Full time

    Job Description:We are hiring aPrior Authorization Specialistto manage and process prior authorization requests for medical treatments. The successful candidate will work closely with physicians, insurance providers, and patients to ensure the authorization process is seamless and efficient. Key Responsibilities:Review and process prior authorization...

  • Medical Authorization Specialist

    1 week ago

    Karachi, Sindh, Pakistan beBeeAuthorization Full time 4,500,000 - 6,000,000

    Job OpportunityWe are seeking a highly skilled professional to manage and process prior authorization requests for medical treatments.About the RoleReview and process prior authorization requests for medical procedures and medications.Coordinate with healthcare providers and insurance companies to obtain necessary approvals.Track and follow up on pending...

  • Verification of Benefits Specialist

    1 week ago

    Karachi, Sindh, Pakistan Medcare Billing (Pvt) Ltd. Full time 600,000 - 800,000 per year

    We're Hiring – Verification of Benefits (VOB) SpecialistMedcare Billing (Pvt) Ltd is looking for a Verification of Benefits Specialist to join our team.Responsibilities:• Verify patients' insurance eligibility and benefits• Contact insurance carriers for coverage details• Accurately document and update patient benefit information• Coordinate with...

  • Healthcare Collaboration Manager

    7 days ago

    Karachi, Sindh, Pakistan beBeeAuthorization Full time $50,000 - $70,000

    Role SummaryThe role of a Patient Engagement Specialist is pivotal in ensuring seamless communication with insurance companies and healthcare providers to obtain prior authorization for medications.This position involves playing a vital role in the healthcare industry by working closely with various stakeholders to facilitate efficient medication...

  • Patient Engagement Specialist

    2 weeks ago

    Karachi, Sindh, Pakistan DataQ Healthcare Full time

    OverviewWork shift: Night from 6 pm to 3 amLocation: Shahrah-e-Faisal, Karachi.Education: Any healthcare degree (Pharm D preferred)Experience: 1+ years of experience in Prior Authorizations is preferred.Job Type: Full-timePay: From Rs70,000.00 per monthWork Location: In personResponsibilitiesMake calls to insurance companies/submit requests through the...

  • Patient Engagement Specialist

    1 week ago

    Karachi, Sindh, Pakistan DataQ Healthcare Full time $70,000 per year

    Work shift: Night from 6 pm to 3 amLocation: Shahrah-e-Faisal, Karachi.Education: Any healthcare degree (Pharm D preferred)Experience: 1+ years of experience in Prior Authorizations is preferred.Job Description:Make calls to insurance companies/submit requests through the online portal to get prior authorization for medications.Ensure all the steps are...

  • Healthcare Relationship Coordinator

    1 week ago

    Karachi, Sindh, Pakistan beBeePatientEngagement Full time 720,000

    Job SummaryWe are seeking a highly skilled and experienced Patient Engagement Specialist to join our team. As a key member of our healthcare organization, you will play a vital role in ensuring seamless communication with patients, insurance companies, and healthcare providers.Your primary responsibility will be to obtain prior authorization for medications,...

  • Medical Clearance Coordinator

    7 days ago

    Karachi, Sindh, Pakistan beBeeHealthcare Full time 600,000 - 1,200,000

    Job TitleWe are seeking a skilled Prior Authorization Specialist to join our team. The ideal candidate will have experience in managing and processing prior authorization requests for medical treatments, working closely with physicians, insurance providers, and patients to ensure a seamless and efficient authorization process.Key Responsibilities:The Prior...

  • U.S. Medical Billing Specialist

    2 weeks ago

    Karachi, Sindh, Pakistan beBeeMedicalBilling Full time 400,000 - 800,000

    U.S. Medical Billing Specialist WantedLocation: On-site Job Night Shift Gulistan-e-Jauhar, Karachi.Job Type: Full-TimeExperience Level: Prior Experience RequiredAbout the OpportunityWe are seeking a detail-oriented and experienced U.S. Medical Billing Specialist to join our growing team.The ideal candidate will have a solid understanding of the U.S. medical...

  • Patient Outreach Specialist

    1 week ago

    Karachi, Sindh, Pakistan MacCare Full time 400,000 - 800,000 per year

    Job Summary:We are seeking talented individuals to join our organization as Patient Outreach Specialists for night shift operations. The specialist will handle both inbound and outbound patient calls, providing essential communication and support regarding patient scheduling, insurance verification, and medical records management.Key Responsibilities:Answer...