Pateint Eligibility

We are looking for a proactive and detail-oriented Insurance Verification & Authorization Specialist to join our medical billing team. In this role, you will be responsible for confirming patient insurance coverage, obtaining necessary pre-authorizations, and ensuring accurate documentation to support seamless billing and claims processing. The ideal candidate will demonstrate excellent communication skills, strong attention to detail, and the ability to navigate payer-specific requirements with efficiency and professionalism.

Key Responsibilities

Insurance Verification & Eligibility

• Verify patient insurance benefits via payer portals or direct contact with insurance representatives.
• Maintain accurate and up-to-date eligibility records in the Electronic Health Record (EHR) system (e.g., eClinicalWorks).
• Complete and upload verification forms for all new patients in a timely manner.
• Clearly communicate estimated out-of-pocket costs to patients.
• Escalate unresolved coverage or balance concerns to the Patient Collections team.
• Proactively follow up with patients to obtain missing or updated insurance information.

Authorizations & Compliance

• Obtain prior authorizations for services requiring insurer pre-approval.
• Ensure compliance with Medicaid and other payer-specific guidelines.
• Coordinate with the Patient Services team for out-of-network cases.
• Secure pre-approvals for psychological evaluations while maintaining accurate documentation and alerts.

Operational Support & Coordination

• Support urgent or same-day appointment scheduling as needed.
• Report billing discrepancies, payer policy changes, and network status updates.
• Collaborate with the Practice Manager to resolve incomplete intake documentation.
• Participate in regular meetings with the Billing Manager to refine workflows, enhance accuracy, and drive efficiency.

Job Type: Full-time

Pay: Rs40, Rs80,000.00 per month

Ability to commute/relocate:

• Wapda Town: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

• Willing to work the night shift?

Experience:

• Medical Billing: 1 year (Preferred)

Language:

• English (Required)

Work Location: In person