Patient Eligibility & Authorization Coordinator

Insurance Verification & Authorization Specialist

We are seeking a highly organized and detail-oriented Insurance Verification & Authorization Specialist to support our healthcare operations and revenue cycle team. This role is responsible for verifying patient insurance eligibility, securing prior authorizations, maintaining accurate documentation, and ensuring compliance with payer requirements. The ideal candidate possesses strong communication skills, exceptional attention to detail, and a thorough understanding of insurance verification and authorization processes within a fast-paced healthcare environment.

Key ResponsibilitiesInsurance Verification & Eligibility Management

• Verify patient insurance benefits and coverage through payer portals, insurance carrier websites, and direct communication with insurance representatives.
• Maintain accurate and up-to-date insurance eligibility records within the Electronic Health Record (EHR) system, including eClinicalWorks (eCW).
• Complete, review, and upload insurance verification documentation for newly registered patients in a timely manner.
• Educate patients regarding their financial responsibilities, including copayments, deductibles, coinsurance, and out-of-pocket costs.
• Identify and investigate eligibility discrepancies, escalating unresolved coverage issues to the appropriate Patient Collections or Revenue Cycle team.
• Proactively contact patients to obtain missing, corrected, or updated insurance information as needed.

Prior Authorization & Compliance

• Obtain and manage prior authorizations for medical, behavioral health, and specialty services requiring payer approval.
• Ensure compliance with Medicaid, Medicare, commercial insurance, and payer-specific authorization requirements.
• Coordinate with Patient Services and clinical teams to address out-of-network insurance situations and authorization challenges.
• Secure authorizations for psychological evaluations and other specialized services while maintaining accurate records and system notifications.
• Monitor authorization expiration dates and ensure timely renewals to prevent interruptions in patient care or reimbursement.

Operational Support & Cross-Functional Collaboration

• Support urgent and same-day appointment scheduling needs by expediting eligibility and authorization verification processes.
• Monitor payer policy updates, coverage changes, authorization requirements, and provider network participation information.
• Collaborate with the Practice Manager and intake staff to resolve incomplete, inaccurate, or missing patient registration and intake documentation.
• Participate in team meetings and process improvement initiatives focused on enhancing workflow efficiency, documentation accuracy, and service quality.
• Assist with special projects and administrative tasks that support operational and revenue cycle objectives.

Core Competencies

• Strong knowledge of insurance verification, benefits eligibility, and prior authorization processes.
• Familiarity with Medicaid, Medicare, commercial insurance plans, and payer guidelines.
• Excellent communication, customer service, and problem-solving skills.
• High attention to detail with strong organizational and documentation abilities.
• Proficiency in EHR systems, including eClinicalWorks (eCW), and insurance verification platforms.
• Ability to prioritize tasks, manage deadlines, and work effectively in a fast-paced healthcare environment.

Pay: Rs40,000.00 - Rs70,000.00 per month

Ability to commute/relocate:

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

Application Question(s):

• Willing to work the night shift at Wapda Town, Lahore?

Experience:

• Medical Billing: 1 year (Preferred)

Language:

• Enlgish (Preferred)

Work Location: In person