Insurance Verification & Eligibility- Medical Billing

We are looking for a highly organized and detail-driven Insurance Verification & Authorization Specialist to join our medical billing team. The selected candidate will be responsible for verifying patient insurance coverage, securing prior authorizations, and maintaining accurate and up-to-date documentation to support seamless billing and claims workflows. The ideal applicant will possess excellent communication skills, strong attention to detail, and a solid understanding of payer requirements, with the ability to work effectively in a fast-paced healthcare environment.

Key ResponsibilitiesInsurance Verification & Eligibility

• Verify patient insurance benefits using payer portals and direct communication with insurance representatives.
• Maintain accurate eligibility information in the Electronic Health Record (EHR) system (e.g., eClinicalWorks).
• Complete and upload insurance verification documents promptly for all new patients.
• Clearly and professionally explain estimated out-of-pocket costs to patients.
• Escalate unresolved coverage issues or financial discrepancies to the Patient Collections team.
• Proactively follow up with patients to obtain missing or updated insurance information.

Authorizations & Compliance

• Obtain prior authorizations for services that require insurer approval.
• Ensure adherence to Medicaid and other payer-specific authorization guidelines.
• Coordinate with the Patient Services team for managing out-of-network insurance cases.
• Secure authorizations for psychological evaluations and maintain accurate documentation and system alerts.

Operational Support & Coordination

• Assist with urgent or same-day appointment scheduling when needed.
• Report updates related to payer policies, billing discrepancies, and provider network status changes.
• Collaborate with the Practice Manager to resolve incomplete patient intake files.
• Participate in routine meetings to enhance workflow efficiency, ensure accuracy, and support continuous process improvements.

Job Type: Full-time

Pay: Rs40,000.00 - Rs70,000.00 per month

Ability to commute/relocate:

• Wapda Town: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

• Willing to work as per the American Timing/Night shift?

Experience:

• Medical Billing: 1 year (Preferred)

Language:

• English (Required)

Work Location: In person