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: ₹23,000.00 - ₹35,000.00 per month
Perks:
Commuter assistance
Food provided
Experience:
elegibility verification & authorization: 1 year (preferred)