Eligibility Executive

We are seeking a detail-oriented Eligibility Executive to verify patient insurance coverage, confirm benefits, and ensure smooth billing processes for our US healthcare clients. This role requires strong communication skills, attention to detail, and familiarity with medical insurance protocols.

Key Responsibilities:

• Verify and confirm patient insurance eligibility and coverage for medical services.
• Collect, update, and maintain accurate patient insurance and demographic information.
• Communicate with insurance providers, healthcare facilities, and patients to resolve eligibility issues.
• Review insurance benefits and limitations, including co-pays, deductibles, and prior authorizations.
• Ensure accurate documentation of all verification activities for auditing and compliance purposes.
• Assist billing and coding teams by providing eligibility information for claims submission.
• Identify and resolve insurance discrepancies, claim rejections, and coverage gaps.
• Maintain up-to-date knowledge of insurance policies, guidelines, and healthcare regulations.
• Collaborate with internal teams to streamline patient intake and billing processes.
• Provide regular reports on eligibility verification status, pending cases, and resolved issues.
• Handle confidential patient and insurance information in accordance with HIPAA and company policies.

Requirements:

• Minimum 6 months’ experience in medical billing or insurance verification.
• Knowledge of US healthcare insurance processes and terminology.
• Strong communication and organizational skills.
• Ability to work independently and handle confidential information.
• Proficiency in MS Office and billing software is a plus.

Job Type: Full-time

Work Location: In person