Position: Eligibility Verification Analyst – US Healthcare
Department: Revenue Cycle Management (RCM)
Location: Baner, Pune
Work Mode: Work from Office
Shift Timing: 1:00 PM to 10:00 PM IST
Experience: 2+ Years
Working Days: 5 Days a Week

Job Summary

We are looking for a detail-oriented Eligibility Verification Analyst with experience in US Healthcare Revenue Cycle Management (RCM). The candidate will be responsible for verifying patients' insurance eligibility and benefits, validating coverage details, and ensuring accurate information is available before medical services are provided.

Key Responsibilities

- Verify patients' insurance eligibility and benefits using insurance portals, payer websites, and other available tools.
- Validate insurance coverage, policy effective dates, termination dates, and plan details.
- Check copayments, deductibles, coinsurance, out-of-pocket maximums, and remaining perks.
- Verify primary and secondary insurance coverage and identify coordination of benefits (COB) requirements.
- Review referral and prior authorization requirements, where applicable.
- Contact insurance companies when required to clarify coverage or resolve discrepancies.
- Accurately document verification results, reference numbers, and benefit details in the relevant systems.
- Identify inactive policies, coverage limitations,



and potential issues that may affect claim submission or reimbursement.
- Coordinate with internal teams to resolve eligibility-related queries and discrepancies.
- Meet daily productivity, quality, and turnaround-time targets while maintaining accuracy and compliance with HIPAA guidelines.

Required Skills and Qualifications

- Minimum 2+ years of experience in US Healthcare Eligibility Verification or Insurance Verification.
- Good understanding of US healthcare insurance plans, including Commercial, Medicare, and Medicaid.
- Knowledge of copayments, deductibles, coinsurance, and out-of-pocket expenses.
- Familiarity with payer portals and eligibility verification tools.
- Good written and verbal communication skills.
- Strong attention to detail, analytical ability, and problem-solving skills.
- Ability to meet productivity and quality targets in a fast-paced environment.
- Basic computer skills and proficiency in MS Office.

Preferred Qualifications

- Experience working in US Healthcare RCM or medical billing operations.
- Familiarity with EHR/PM systems and electronic eligibility transactions such as 270/271.
- Understanding of HIPAA and patient data confidentiality requirements.

Pay: ₹400,000.00 - ₹500,000.00 per year

Benefits:

- Health insurance
- Paid sick time

Work Location: In person

📌 Eligibility Verification Analyst - US Healthcare (Baner)
🏢 Synergy Healthcare and Life Science
📍 Baner