Patient Eligibility & Authorization Coordinator-Medical Billing

We are seeking a proactive and detail-oriented Insurance Verification & Authorization Specialist to join our medical billing team. This role is responsible for verifying patient insurance coverage, securing required pre-authorizations, and maintaining accurate documentation to support efficient billing and claims processing. The ideal candidate will have strong attention to detail, excellent communication skills, and the ability to navigate payer-specific requirements with accuracy and professionalism.

Key ResponsibilitiesInsurance Verification & Eligibility

• Verify patient insurance benefits through payer portals or direct contact with insurance representatives.
• Maintain up-to-date eligibility records within the Electronic Health Record (EHR) system (e.g., eClinicalWorks).
• Complete and upload insurance verification forms for all new patients in a timely manner.
• Communicate estimated out-of-pocket costs to patients clearly and professionally.
• Escalate unresolved coverage or balance concerns to the Patient Collections team.
• Follow up with patients proactively to obtain missing or updated insurance information.

Authorizations & Compliance

• Obtain prior authorizations for services requiring insurer pre-approval.
• Ensure strict compliance with Medicaid and other payer-specific authorization requirements.
• Coordinate with the Patient Services team for out-of-network cases.
• Secure pre-approvals for psychological evaluations, maintaining accurate documentation and alerts.

Operational Support & Coordination

• Assist with urgent or same-day appointment scheduling when necessary.
• Report discrepancies related to billing, payer policy changes, or provider network updates.
• Collaborate with the Practice Manager to resolve incomplete intake documentation.
• Participate in regular meetings with the Billing Manager to improve workflows, accuracy, and efficiency.

Job Type: Full-time

Pay: Rs40,000.00 - Rs80,000.00 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?

Experience:

• Medical Billing: 1 year (Preferred)

Language:

• English (Required)

Work Location: In person