Prior Authorization & Insurance Eligibility Verification Specialist Ophthalmology

Experience: 2 3 Years
Employment Type: Full time

Job Summary

We are looking for an experienced Prior Authorization & Insurance Eligibility Verification Specialist with healthcare/ophthalmology experience to support U.S.-based eye care operations.

Key Responsibilities
Verify patient insurance eligibility, benefits, copays, deductibles, and coverage limits.
Process and follow up on prior authorization requests with insurance payers.
Submit required clinical documentation and track approvals, denials, and expiration dates.
Identify and resolve insurance, payer ID, and plan-related discrepancies.
Communicate with patients regarding insurance advantages and appointment-related requirements.




Maintain accurate authorization and eligibility records.
Coordinate with the practice team regarding pending cases and missing documentation.

Requirements
2 3 years of hands-on experience in Prior Authorization and Insurance Eligibility Verification.
Ophthalmology/Optometry experience preferred.
Knowledge of Commercial, Medicare, and Medicaid payers.
Experience with EHR/Practice Management systems and payer portals.
Strong communication skills and positive knowledge of U.S. healthcare insurance processes.
NextTech/NextGen experience is a plus.
Healthcare academic background such as PharmD, MHA, MBBS, or similar is preferred.

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📌 Prior Authorization & Insurance Eligibility Verification Specialist – Ophthalmology Telangana (India)
🏢 Staffingly
📍 India