Qureos Mentor

Macrise Tech Solutions

We are seeking a highly organized and detail-oriented Insurance Verification &amp; Authorization Specialist to join our medical billing team. This role is critical in ensuring accurate verification of patient insurance coverage, obtaining timely prior authorizations, and maintaining complete and compliant documentation to support efficient billing and claims processing.The ideal candidate will have excellent communication skills, strong attention to detail, and a solid understanding of payer requirements, with the ability to thrive in a fast-paced healthcare environment.Key ResponsibilitiesInsurance Verification &amp; Eligibility<ul><li>Verify patient insurance coverage through payer portals and direct communication with insurance providers.</li><li>Maintain accurate and up-to-date eligibility records within the Electronic Health Record (EHR) system (e.g., eClinicalWorks).</li><li>Complete and upload insurance verification documentation promptly for all newly registered patients.</li><li>Clearly communicate estimated patient financial responsibilities, including copayments, deductibles, and out-of-pocket expenses.</li><li>Escalate unresolved eligibility discrepancies or coverage concerns to the Patient Collections team when necessary.</li><li>Proactively follow up with patients to obtain missing, corrected, or updated insurance information.</li></ul>Authorizations &amp; Compliance<ul><li>Obtain prior authorizations for medical and behavioral health services requiring insurance approval.</li><li>Ensure compliance with Medicaid and other payer-specific authorization guidelines and policies.</li><li>Coordinate with the Patient Services team to manage out-of-network insurance cases.</li><li>Secure authorizations for psychological assessments while maintaining accurate documentation and system alerts.</li></ul>Operational Support &amp; Collaboration<ul><li>Assist with urgent or same-day appointment scheduling as needed.</li><li>Monitor and communicate updates related to payer policies, billing concerns, and provider network participation.</li><li>Collaborate with the Practice Manager to resolve incomplete or inaccurate patient intake documentation.</li><li>Participate in team meetings to improve workflow efficiency, enhance data accuracy, and support continuous process improvements.</li></ul>Job Type: Full-timePay: Rs45,000.00 - Rs70,000.00 per monthAbility to commute/relocate:<ul><li>Wapda Town: Reliably commute or planning to relocate before starting work (Required)</li></ul>Application Question(s):<ul><li>Willing to work the night shift in Wapda Town, Lahore?</li></ul>Experience:<ul><li>Medical Billing: 1 year (Preferred)</li></ul>Language:<ul><li>English (Required)</li></ul>Work Location: In person

VOB & Pre-Authorization Specialist

Patient Communication &amp; Call Management<ul><li>Initiate outbound calls and follow-up messages to patients regarding outstanding balances, payment reminders, and billing-related inquiries.</li><li>Manage inbound calls from patients concerning billing statements, account balances, payment arrangements, and general questions.</li><li>Communicate in a clear, professional, and empathetic manner to address patient concerns and provide accurate billing information.</li></ul>Billing &amp; Payment Processing<ul><li>Accurately post both patient and insurance payments within the billing system.</li><li>Process manual receipts while ensuring all financial transactions are properly recorded and documented.</li><li>Generate and distribute electronic billing statements (e-Statements) in a timely manner.</li><li>Set up, monitor, and manage patient payment plans in accordance with organizational policies.</li><li>Execute scheduled payment plan charges and ensure accurate posting of all transactions.</li></ul>Account Management<ul><li>Identify and resolve account discrepancies by reviewing posting errors and making necessary balance adjustments.</li><li>Review and update patient account information to maintain accuracy throughout the billing lifecycle.</li><li>Ensure all billing activities are fully documented and traceable within the system.</li></ul>Encounter &amp; Documentation Management<ul><li>Review patient encounters to ensure charges are accurately entered and aligned with services rendered.</li><li>Coordinate with internal teams to resolve missing, incomplete, or incorrect encounter information.</li><li>Maintain organized, accurate, and up-to-date billing records within the practice management system.</li></ul>Job Type: Full-timePay: Rs45,000.00 - Rs70,000.00 per monthAbility to commute/relocate:<ul><li>Wapda Town: Reliably commute or planning to relocate before starting work (Required)</li></ul>Application Question(s):<ul><li>Willing to work the night shift in Wapda Town, Lahore?</li></ul>Experience:<ul><li>Medical Billing: 1 year (Preferred)</li></ul>Language:<ul><li>English (Required)</li></ul>Work Location: In person

Payment Posting & Patient Accounts Specialist

The Credentialing Specialist is responsible for managing the complete lifecycle of provider credentialing and re-credentialing across various insurance networks, payers, and credentialing platforms. This role requires a proactive, detail-oriented professional with strong follow-up capabilities to ensure ongoing regulatory compliance, uninterrupted provider participation, and efficient billing and authorization workflows. The position plays a critical role in supporting operational efficiency and ensuring accurate, timely reimbursements.Key ResponsibilitiesCredentialing &amp; Compliance<ul><li>Maintain, organize, and regularly update provider credentialing records for both commercial and government payers.</li><li>Oversee and manage CAQH profiles to ensure compliance with CMS regulations and payer-specific credentialing standards.</li><li>Process initial credentialing, re-credentialing, and payer enrollment applications for Medicare, Medicaid, and commercial insurance networks.</li><li>Manage applications, renewals, and documentation related to professional licenses, DEA registrations, and controlled substance certifications.</li><li>Complete provider revalidation processes with government and regulatory bodies within required timelines.</li><li>Coordinate hospital credentialing activities, including managing provider privileges and maintaining active affiliations.</li></ul>Collaboration &amp; Operational Support<ul><li>Work closely with the Revenue Cycle Director and Billing Team to resolve credentialing-related denials, payer concerns, and authorization delays.</li><li>Ensure provider data is accurate and consistent across CAQH, PECOS, NPPES, CMS databases, and internal systems.</li><li>Maintain a centralized credentialing tracker, including provider credentials, expiration dates, payer participation status, and system access information.</li><li>Provide administrative support for credentialing audits, compliance reviews, and regulatory documentation as required</li></ul>Job Type: Full-timePay: Rs45,000.00 - Rs80,000.00 per monthAbility to commute/relocate:<ul><li>Wapda Town: Reliably commute or planning to relocate before starting work (Required)</li></ul>Application Question(s):<ul><li>Willing to work the night shift in Wapda Town, Lahore?</li></ul>Experience:<ul><li>Credentialing: 1 year (Preferred)</li></ul>Language:<ul><li>English (Required)</li></ul>Work Location: In person

Payer Enrollment & Credentialing Specialist

Accounts Receivable &amp; Denial Management<ul><li>Oversee and manage outstanding insurance claims to help reduce overall Accounts Receivable (AR) balances.</li><li>Perform routine follow-ups on denied claims to ensure timely resolution and optimize recovery outcomes.</li><li>Review Electronic Remittance Advice (ERA) reports to identify recurring denial trends and recommend preventive and corrective actions.</li><li>Prepare, submit, and track appeals for denied or underpaid claims, ensuring all supporting documentation is complete and accurate.</li><li>Investigate payment discrepancies and escalate complex or unresolved issues to the Billing Manager when necessary.</li><li>Maintain accurate and up-to-date AR aging reports, providing regular weekly and monthly performance updates.</li><li>Manage billing and claims for specialized services, including TMS, Spravato, and psychological assessments.</li><li>Partner with the Billing Manager to achieve AR reduction, recovery, and accuracy goals.</li></ul>Patient &amp; Provider Communication<ul><li>Respond promptly and professionally to billing-related inquiries from patients, providers, and internal stakeholders.</li><li>Review and verify patient account information before initiating collections or claim follow-ups.</li><li>Collaborate with providers to resolve claim issues, including coding errors and missing documentation.</li><li>Communicate with insurance payers regarding eligibility, prior authorizations, and network participation.</li><li>Address patient concerns with professionalism and empathy, including processing refunds when applicable.</li></ul>Systems Management &amp; Process Improvement<ul><li>Create, monitor, and resolve billing-related support tickets within the eClinicalWorks (eCW) system.</li><li>Provide guidance and support to team members on AR follow-up strategies and denial resolution workflows.</li><li>Coordinate with U.S.-based billing teams to ensure accurate and timely claim submissions.</li><li>Participate in operational meetings to review performance metrics, analyze trends, and recommend process improvements.</li><li>Stay up to date with payer policies, regulatory requirements, and industry best practices in medical billing and reimbursement.</li></ul>Job Type: Full-timePay: Rs45,000.00 - Rs70,000.00 per monthAbility to commute/relocate:<ul><li>Wapda Town: Reliably commute or planning to relocate before starting work (Required)</li></ul>Application Question(s):<ul><li>Willing to work the night shift in Wapda Town, Lahore?</li></ul>Experience:<ul><li>Medical Billing: 1 year (Preferred)</li></ul>Language:<ul><li>English? (Required)</li></ul>Work Location: In person

Medical Billing & AR Specialist

Join Macrise Tech Solutions and explore 4   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Macrise Tech Solutions

About Company

VOB & Pre-Authorization Specialist

Payment Posting & Patient Accounts Specialist

Payer Enrollment & Credentialing Specialist

Medical Billing & AR Specialist