We are looking for a highly organized and detail-focused Insurance Verification & Authorization Specialist to join our medical billing team. This role is essential in ensuring accurate patient insurance verification, securing timely prior authorizations, and maintaining complete and compliant documentation to support efficient billing and claims processing.
The ideal candidate will possess strong communication skills, exceptional attention to detail, and a thorough understanding of payer requirements, with the ability to perform effectively in a fast-paced healthcare environment.
Key ResponsibilitiesInsurance Verification & Eligibility
- Verify patient insurance coverage through payer portals and direct communication with insurance providers.
- Maintain accurate and up-to-date eligibility records within the Electronic Health Record (EHR) system (e.g., eClinicalWorks).
- Complete and upload insurance verification documentation promptly for all newly registered patients.
- Clearly explain estimated patient financial responsibilities, including copayments, deductibles, and out-of-pocket expenses.
- Escalate unresolved eligibility discrepancies or coverage issues to the Patient Collections team when required.
- Proactively follow up with patients to obtain missing, corrected, or updated insurance information.
Authorizations & Compliance
- Obtain prior authorizations for medical and behavioral health services requiring insurance approval.
- Ensure compliance with Medicaid and other payer-specific authorization guidelines and policies.
- Coordinate with the Patient Services team to manage out-of-network insurance cases.
- Secure authorizations for psychological assessments while maintaining accurate documentation and system alerts.
Operational Support & Collaboration
- Assist with urgent or same-day appointment scheduling as needed.
- Track and communicate updates related to payer policies, billing concerns, and provider network participation.
- Collaborate with the Practice Manager to resolve incomplete or inaccurate patient intake documentation.
- Participate in team meetings to enhance workflow efficiency, improve data accuracy, and support continuous process improvement.
Job Type: Full-time
Pay: Rs45,000.00 - 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 the night shift in Wapda Town, Lahore?
Experience:
- Medical Billing: 1 year (Preferred)
Language:
Work Location: In person