Patient Eligibility

2 weeks ago

Wapda Town, Pakistan Macrise Tech Solutions Full time 960,000 per year

We are seeking a proactive and detail-oriented Insurance Verification & Authorization Specialist to join our medical billing team. This role is responsible for verifying patient insurance coverage, securing required pre-authorizations, and maintaining accurate documentation to support efficient billing and claims processing. The ideal candidate will have strong attention to detail, excellent communication skills, and the ability to navigate payer-specific requirements with accuracy and professionalism.

Key ResponsibilitiesInsurance Verification & Eligibility

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

Authorizations & Compliance

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

Operational Support & Coordination

  • Assist with urgent or same-day appointment scheduling when necessary.
  • Report discrepancies related to billing, payer policy changes, or provider network updates.
  • Collaborate with the Practice Manager to resolve incomplete intake documentation.
  • Participate in regular meetings with the Billing Manager to improve workflows, accuracy, and 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

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