Qureos Mentor

Macrise Tech Solutions

We are looking for a highly organized and detail-focused Insurance Verification &amp; Authorization Specialist to join our medical billing team. This role is essential in ensuring accurate insurance eligibility verification, securing timely prior authorizations, and maintaining complete documentation to support efficient billing and claims processing. The ideal candidate possesses strong communication skills, exceptional attention to detail, and a solid understanding of payer guidelines, with the ability to perform effectively 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 carriers.</li><li>Maintain accurate and up-to-date eligibility records within the Electronic Health Record (EHR) system, such as eClinicalWorks.</li><li>Complete, upload, and document insurance verification information promptly for all new patient registrations.</li><li>Clearly communicate estimated patient financial responsibility, including copays, deductibles, and out-of-pocket expenses.</li><li>Escalate unresolved eligibility discrepancies or coverage issues 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; Regulatory Compliance<ul><li>Obtain prior authorizations for medical and behavioral health services requiring payer approval.</li><li>Ensure compliance with Medicaid and other payer-specific authorization policies and procedures.</li><li>Collaborate 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 when required.</li><li>Monitor and communicate updates related to payer policies, billing issues, and provider network participation.</li><li>Work closely with the Practice Manager to resolve incomplete or inaccurate patient intake documentation.</li><li>Participate in team meetings to improve workflows, enhance data accuracy, and support continuous process improvement initiatives.</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 in the USA time?</li></ul>Experience:<ul><li>Medical Billing: 1 year (Preferred)</li></ul>Language:<ul><li>English (Required)</li></ul>Work Location: In person

Verification of Benefits-Medical Billing

Patient Communication &amp; Call Handling<ul><li>Conduct outbound calls and send follow-up communications to patients regarding outstanding balances, payment reminders, and billing-related issues.</li><li>Manage inbound calls related to billing statements, account balances, payment arrangements, and general inquiries.</li><li>Communicate clearly, professionally, and empathetically to address patient concerns and provide accurate billing information.</li></ul>Billing &amp; Payment Administration<ul><li>Accurately post patient and insurance payments within the billing system.</li><li>Process manual receipts and ensure 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, oversee, and manage patient payment plans in compliance with organizational guidelines.</li><li>Execute scheduled payment plan charges and ensure accurate transaction posting.</li></ul>Accounts Oversight<ul><li>Identify and resolve account discrepancies by reviewing posting errors and making appropriate balance adjustments.</li><li>Review and update patient account information to maintain accuracy throughout the billing cycle.</li><li>Ensure all billing activities are properly documented and traceable within the system.</li></ul>Encounter &amp; Documentation Control<ul><li>Review patient encounters to verify accurate charge entry aligned with services rendered.</li><li>Collaborate with internal teams to resolve incomplete, missing, or incorrect encounter data.</li><li>Maintain organized, accurate, and up-to-date billing documentation within the practice management system.</li></ul>Job Type: Full-timePay: Rs45,000.00 - Rs70,000.00 per monthWork Location: In person

Patient Collection Associate-Medical Billing

Accounts Receivable &amp; Denial Resolution<ul><li>Oversee and resolve outstanding insurance claims to reduce overall Accounts Receivable (AR) balances.</li><li>Conduct daily follow-ups on denied claims to ensure timely and effective resolution.</li><li>Review Electronic Remittance Advice (ERA) reports to identify recurring denial trends and implement corrective or preventive measures.</li><li>Prepare, submit, and monitor appeals for denied or underpaid claims, ensuring all supporting documentation is accurate and complete.</li><li>Investigate payment discrepancies and escalate complex or unresolved issues to the Billing Manager when necessary.</li><li>Maintain accurate AR aging reports and provide consistent weekly and monthly performance updates.</li><li>Manage billing and claims processing for specialized services, including TMS, Spravato, and psychological evaluations.</li><li>Collaborate closely with the Billing Manager to achieve AR recovery, reduction, and accuracy targets.</li></ul>Patient &amp; Provider Coordination<ul><li>Respond promptly and professionally to billing inquiries from patients, providers, and internal stakeholders.</li><li>Review and update patient account information to ensure accuracy before initiating collection efforts.</li><li>Work with providers to resolve claim-related issues, including coding inaccuracies and incomplete documentation.</li><li>Communicate with insurance payers regarding eligibility verification, prior authorizations, and network participation.</li><li>Address patient billing concerns with empathy and professionalism, including processing refunds when appropriate.</li></ul>Systems &amp; Process Improvement<ul><li>Create, monitor, and resolve billing-related support tickets within eClinicalWorks (eCW).</li><li>Provide coaching and guidance to team members on AR follow-up procedures and denial management workflows.</li><li>Coordinate with U.S.-based billing teams to ensure accurate and timely claim submissions.</li><li>Participate in operational meetings and performance reviews to analyze trends and recommend process enhancements.</li><li>Stay current with payer policies, regulatory updates, and 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 in the USA Time 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

Accounts Receivable & Denials-Medical Billing

Join Macrise Tech Solutions and explore 3   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

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Verification of Benefits-Medical Billing

Patient Collection Associate-Medical Billing

Accounts Receivable & Denials-Medical Billing