Insurance Eligibility & Verification Specialist

Experience: 1–3 Years

Shift: US/Night Shift

Industry: US Healthcare / RCM

Job Summary

We are looking for an Insurance Eligibility & Verification Specialist with 1–3 years of experience in US Healthcare RCM. The candidate should have hands-on experience in demographics verification, insurance eligibility and benefits verification, payer portals, and basic charge entry.

Key Responsibilities
Verify patient demographics, insurance eligibility, and advantages.
Check copay, deductible, coinsurance, and out-of-pocket maximums.
Verify insurance coverage through payer portals and insurance websites.
Handle Medicare, Medicaid, and Commercial Insurance verification.
Check prior authorization and referral requirements for physician/provider services.
Review patient and insurance information before charge posting.
Perform charge entry and charge capture using CPT/HCPCS and diagnosis codes.
Verify DOS, provider, place of service, insurance details, modifiers, and units.




Identify missing or incorrect information and coordinate for corrections.
Maintain accurate verification and charge-related documentation.
Support clean claim submission and help prevent eligibility and charge-related denials.
Follow HIPAA and patient confidentiality requirements.

Required Skills
1–3 years of experience in US Healthcare RCM / Insurance Verification / Eligibility.
Robust knowledge of insurance eligibility and perks verification.
Experience with Medicare, Medicaid, and Commercial Insurance.
Experience using payer portals such as Availity and UHC.
Knowledge of CPT/HCPCS, diagnosis codes, DOS, POS, modifiers, and units.
Basic understanding of physician/provider billing and charge entry.
Good communication, analytical, and documentation skills.
Ability to meet productivity and quality targets.
Willingness to work in US/night shifts.

Pay: ₹20,000.00 - ₹40,000.00 per month

Benefits
Leave encashment
Paid sick time

Work Location: In person

📌 Insurance Verification & Physician Services Executive Mandaveli
🏢 ANAND TECHVERCE
📍 Mandaveli