Key Responsibilities

Insurance Eligibility & Benefits Verification
Verify patient insurance eligibility and coverage prior to scheduled services.
Review active/inactive status, effective dates, termination dates, plan type, and coverage details.
Verify patient perks
Verify advantages for specific CPT/HCPCS and procedure codes when required.
Identify primary, secondary, and tertiary insurance coverage.
Confirm coordination of perks (COB) information when applicable.
Review payer-specific requirements and benefit limitations.
Accurately document verification results in the designated system.

Authorization Management
Obtain authorization from insurance companies through payer portals, phone, fax, or other approved channels.




Submit authorization requests with accurate patient, provider, diagnosis, and procedure information.
Track authorization requests from submission through approval, modification, or denial.
Maintain accurate authorization numbers, approved CPT codes, units, dates of service, and validity periods.
Identify services that require authorization and communicate requirements promptly to the appropriate internal teams.
Follow up with payers on pending authorization requests.
Ensure authorization information is available and accurate before the date of service.

📌 Eligibility Verification Ev & Authorization Specialist Ahmedabad (India)
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📍 India