Key Roles

Perform end-to-end Insurance Eligibility & Benefits Verification before patient visits

Verify active coverage, copays, deductibles, coinsurance, visit limits, and Coordination of Perks (COB)

Identify behavioral health carve-outs and verify benefits with the correct payer

Submit, track, and manage Prior Authorization requests and authorization renewals

Verify PCP referral requirements and authorization validity

Work with payer portals and insurance representatives to resolve eligibility and authorization issues

Document verification results accurately in the client EHR

Escalate coverage, authorization, and eligibility issues before the date of service

Create SOPs, train team members, and support quality improvement initiatives

Key Skills

Insurance Eligibility Verification





Verification of Benefits (VOB)

Prior Authorization

Behavioral Health

Psychiatry & ABA Services

Availity

Optum Provider Portal

Valant EHR

Medicare Part B & Medicaid

Commercial Insurance Verification

Coordination of Benefits (COB)

HIPAA Compliance

Communication & Documentation

Preferred Experience

Behavioral Health RCM or Healthcare BPO

Eligibility-related Denials & Appeals

SOP Development & Team Training

Clearinghouse & Basic AR Follow-Up Experience

Experienced Candidates Only Freshers are not eligible for this position.

📌 Senior Insurance Eligibility and Verification Specialist (Hyderabad)
🏢 Staffingly
📍 Hyderabad