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insurance verification specialist

Mac Care

We are seeking a detail-oriented and analytical Insurance Verification &amp; Eligibility Specialist to join our Revenue Cycle team. The ideal candidate will be responsible for verifying patient insurance coverage, determining eligibility, obtaining prior authorizations, and ensuring accurate documentation to support timely claim submission and payment. This role is critical in reducing claim denials, accelerating reimbursements, and supporting overall financial performance in a U.S. healthcare environment.Key Responsibilities: Insurance Verification &amp; Eligibility:<ul><li>Verify patient insurance coverage (commercial, Medicare, Medicaid, and other payers) prior to appointments or services.</li><li>Confirm benefits, deductibles, co-insurance, co-payments, policy limitations, and exclusions.</li><li>Review and interpret payer portals, EHR systems, and clearinghouses for real-time eligibility updates.</li><li>Ensure accurate documentation of verified benefits in the system.</li></ul>Authorization &amp; Pre-Certification:<ul><li>Obtain prior authorizations as required by payers for specific procedures, diagnostic tests, or treatments.</li><li>Communicate with insurance companies to resolve authorization discrepancies or incomplete information.</li><li>Track authorization status and follow up to secure approvals before service dates.</li></ul>Communication &amp; Coordination:<ul><li>Coordinate with providers, schedulers, and billing teams to ensure all insurance-related requirements are met prior to patient appointments.</li><li>Communicate coverage issues, payer requirements, or eligibility concerns to relevant teams promptly.</li><li>Provide guidance to patients regarding coverage expectations, if required.</li></ul>Documentation &amp; Data Accuracy:<ul><li>Maintain complete and accurate patient insurance information in the practice management or billing system.</li><li>Document all interactions, verification results, and authorization details in compliance with organizational policies.</li><li>Identify and correct missing or outdated insurance information.</li></ul>Denial Prevention &amp; RCM Support:<ul><li>Identify potential coverage issues that may result in claim denials.</li><li>Work closely with AR and Billing teams to support clean claim submission.</li><li>Review denial trends related to coverage or eligibility and provide feedback to the team.</li></ul>Qualifications &amp; Requirements:Education:<ul><li>Bachelor&rsquo;s degree preferred, but not mandatory.</li><li>High school diploma or equivalent required.</li></ul>Experience:<ul><li>1&ndash;2 years of experience in U.S. Healthcare Revenue Cycle Management (Insurance Verification, Eligibility, Front-End RCM).</li><li>Experience with commercial insurances, Medicare, Medicaid, and managed care plans preferred.</li><li>Familiarity with EMR systems, clearinghouses, and payer portals.</li></ul>Job Type: Full-timeWork Location: In person

Insurance Verification-Eligibility Specialist

Zue Pvt Ltd

Job Title: Physician Billing Specialist Location: Main Shahra-e-Faisal, Karachi Employment Type: Full-time and On-site Shift Timings: 06:00 PM to 03:00 AM PKT Working Days: Monday to FridayAbout the Role:We are looking for adetail-oriented and proactive Physician Billing Specialist to join our team. You will ensure accurate insurance verification, follow up on unpaid or denied claims, and maintain compliance with billing regulations. Your work will directly support our physicians and help streamline revenue processes.Job Responsibilities:<ul><li>Insurance Verification:</li></ul>Ensure patient insurance info is accurate and up-to-date. Validate insurance plan status, ID numbers, patient names, and DOBs.<ul><li>Claims Follow-Up &amp; Resolution:</li></ul>Investigate unpaid or denied claims across all insurance carriers. Challenge &ldquo;no claim found&rdquo; responses and provide proof of submission. Escalate issues to supervisors when necessary to ensure resolution.<ul><li>Documentation &amp; Communication:</li></ul>Record all interactions with insurance representatives in Nextech, including call reference IDs and summaries. Maintain detailed notes to ensure continuity for future follow-ups.<ul><li>Compliance &amp; Timeliness:</li></ul>Ensure claim-related actions meet payer-specific filing and appeal deadlines. Follow HIPAA and federal/state billing regulations. Communicate urgent claim issues requiring physician or clinic staff input.Job Requirements:<ul><li>Previous experience in physician billing, insurance verification, or claims follow-up.</li><li>Familiarity with Nextech or similar EHR/Billing systems preferred.</li><li>Strong attention to detail and organizational skills.</li><li>Excellent communication skills for interacting with insurance representatives.</li><li>Knowledge of HIPAA regulations and medical billing compliance.</li></ul>Perks &amp; Benefits:<ul><li>OPD &amp; IPD health coverage for self, dependents, and parents.</li><li>Life insurance for self.</li><li>Fuel card for male employees.</li><li>Free pick &amp; drop for female employees.</li><li>In-house gym facility.</li><li>Paid leaves &amp; US holidays.</li><li>Referral bonus program.</li></ul>Job Type: Full-timeApplication Question(s):<ul><li>What is your current salary? </li><li>What is your expected salary? </li><li>If selected? Would you be able to join immediately? </li><li>Residential Area in Karachi? </li><li>Are you comfortable working onsite from 06:00 PM to 03:00 AM PKT (Night Shift)? </li></ul>Work Location: In person

Physician Billing Specialist

Explosion Services

We are looking for a dedicated and empathetic Experienced Customer Service Representative (CSR) to join our Durable Medical Equipment (DME) campaign. The CSR will handle inbound and outbound calls, verify insurance details, assist patients with equipment orders, and ensure top-tier service in accordance with HIPAA regulations and DME compliance standards.Key Responsibilities:Verify insurance eligibility, benefits, and coverage for DME items.Educate patients on proper use and maintenance of DME.Explain patient responsibility and out-of-pocket costs clearly and professionally.Coordinate with healthcare providers, insurance companies, and internal departments.Handle sensitive patient information with confidentiality and compliance (HIPAA).Escalate issues to supervisors when necessary for resolution.Qualifications:Minimum of 6 months of experience in a healthcare/DME customer service role.Familiarity with insurance verification and prior authorization processes.Excellent communication skills.Comfortable working in a fast-paced, target-driven environment.Must be HIPAA compliant and aware of medical privacy regulations.Preferred Skills:BPO or call center experience in a US healthcare campaign.Ability to multitask and manage high call volumes.Empathetic, patient-focused, and detail-oriented.Job Type: Full-timeJob Types: Full-time, Part-time, FresherWork Location: In personJob Type: Full-timePay: Rs30,000.00 - Rs45,000.00 per monthWork Location: In person

Calling agent(Experience only)

Cyber Hub Technology

About the Role:We are looking for a proactive and detail-oriented professional to join our Revenue Cycle Management (RCM) team. The role involves communicating with medical insurance companies to verify patient eligibility, benefits, and authorizations while ensuring smooth coordination between internal teams and external stakeholders.Responsibilities<ul><li>Handle inbound and outbound calls with medical insurance companies to verify patient information.</li><li>Communicate with insurance representatives to resolve queries related to eligibility, benefits, and authorizations.</li><li>Perform patient eligibility and benefits verification according to client requirements.</li><li>Coordinate with insurance companies while adhering to organizational information security guidelines.</li><li>Manage call queues and assigned tasks based on priorities set by the Team Leader or Supervisor.</li><li>Maintain accurate documentation and provide daily task updates/sign-off to the Team Leader or Supervisor.</li><li>Ensure high-quality service delivery to both internal teams and external stakeholders.</li><li>Follow company information security and privacy policies in all tasks.</li><li>Safeguard company and client data from unauthorized access, disclosure, or misuse.</li><li>Support additional operational tasks assigned by the Team Leader or Supervisor.</li></ul>Tools / SkillsRequired Skills<ul><li>Strong verbal and written communication skills.</li><li>Excellent interpersonal and customer service skills.</li><li>Good listening and comprehension abilities.</li><li>Strong problem-solving mindset.</li><li>Ability to manage inbound and outbound calls effectively.</li><li>Ability to use positive and professional language while interacting with clients and insurance representatives.</li></ul>Job Type: Full-timePay: Rs70,000.00 - Rs90,000.00 per monthWork Location: In person

Sales Executive -- Medical Billing

About the Role:We are looking for a proactive and detail-oriented professional to join our Revenue Cycle Management (RCM) team. The role involves communicating with medical insurance companies to verify patient eligibility, benefits, and authorizations while ensuring smooth coordination between internal teams and external stakeholders.Responsibilities<ul><li>Handle inbound and outbound calls with medical insurance companies to verify patient information.</li><li>Communicate with insurance representatives to resolve queries related to eligibility, benefits, and authorizations.</li><li>Perform patient eligibility and benefits verification according to client requirements.</li><li>Coordinate with insurance companies while adhering to organizational information security guidelines.</li><li>Manage call queues and assigned tasks based on priorities set by the Team Leader or Supervisor.</li><li>Maintain accurate documentation and provide daily task updates/sign-off to the Team Leader or Supervisor.</li><li>Ensure high-quality service delivery to both internal teams and external stakeholders.</li><li>Follow company information security and privacy policies in all tasks.</li><li>Safeguard company and client data from unauthorized access, disclosure, or misuse.</li><li>Support additional operational tasks assigned by the Team Leader or Supervisor.</li></ul>Required Skills<ul><li>Strong verbal and written communication skills.</li><li>Excellent interpersonal and customer service skills.</li><li>Good listening and comprehension abilities.</li><li>Strong problem-solving mindset.</li><li>Ability to manage inbound and outbound calls effectively.</li><li>Ability to use positive and professional language while interacting with clients and insurance representatives.</li></ul>Job Type: Full-timePay: Rs60,000.00 - Rs90,000.00 per monthExperience:<ul><li>Customer Support / Client Service- Medical Billing: 1 year (Preferred)</li></ul>Language:<ul><li>English (Required)</li></ul>Work Location: In person

Customer Service Executive / Account Manager - Medical Billing

Exavail

We are hiring a dedicated and experienced Verification Officer for a medical provider handling California Workers&rsquo; Compensation cases. This is a full-time night shift remote position. Work from home will be on an if and when basis, depending on performance and operational requirements.The ideal candidate must have excellent English communication skills, strong follow-up abilities, and prior experience in workers&rsquo; compensation verification, collections, and reporting.Responsibilities:Verify claim files with insurance adjusters and Defense AttorneysFollow up on claim status, billing status, and outstanding balancesMaintain accurate daily reports and updates in ExcelCommunicate professionally via phone and email with adjusters, attorneys, and clientsReview documentation and ensure all files are properly updatedHandle collections and payment follow-upsMeet daily productivity and reporting targetsRequirements:Fluent in spoken and written EnglishStrong knowledge of Microsoft Excel (tracking, reporting, updates)Experience with California Workers&rsquo; Compensation claimsKnowledge of adjuster and Defense Attorney verification processUnderstanding of collections and account receivable follow-upStrong attention to detail and organizational skillsAbility to work independently during night shift hoursWork From Home Requirements (If and When Basis):Personal laptop or desktop computerNoise-cancelling headset/headphonesStable high-speed internet connectionReliable power backup (UPS / inverter / generator)Quiet and professional workspacePreferred:Previous experience with medical providers, lien collections, or WC billingFamiliarity with EAMS, or related portalsJob Type: Full-TimeShift: Night ShiftLocation: Remote / Work From Home (If and When Basis)Pay: Rs30,000.00 - Rs45,000.00 per monthWork Location: Hybrid remote in Karachi

Verification Officer – California Workers’ Compensation (Medical Provider)

CodeNinja Inc.

<div>
 
 About CodeNinja
 
 
 
 CodeNinja is a next-generation technology consulting firm specialising in AI-powered transformation, enterprise software delivery, and Quality Engineering. Headquartered in the Gulf region and operating across the MENA, South Asia, and global markets, CodeNinja partners with Tier-1 banks, government entities, and large enterprises to design, build, and run mission-critical technology programs.
 
 
 With deep expertise in QA transformation, test automation, DevOps modernisation, and AI/ML engineering, CodeNinja's teams combine global delivery standards with in-market contextual knowledge &mdash; ensuring outcomes that are compliant, scalable, and commercially aligned with client objectives.
 
 
 For the Client's Test Management Enablement &amp; Automation engagement, CodeNinja brings a dedicated 12-person specialist team spanning Test Management, Automation Engineering, AI/ML, and Performance Testing &mdash; all governed under a structured 20-week program delivery framework.
 
 
 
 About The Role
 
 
 
 The Senior Performance Engineer designs and develops performance scripts for core banking, digital channel, open banking, cards, and payment flows. This role runs load, stress, spike, and endurance cycles, and produces detailed analytical reports to guide infrastructure and application tuning.
 
 
 
 Key Responsibilities
 
 
 
 <ul>
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 Design and develop performance test scripts for core banking, digital channels, open banking, cards, and payment flows
 </li>
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 Parameterise scripts with masked/synthetic test data aligned with SAMA requirements
 </li>
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 Execute load testing at 100%, 150%, and 200% of expected peak load (Ramadan, salary day scenarios)
 </li>
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 Run stress tests to identify breaking points and system behaviour under extreme conditions
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 Execute spike tests simulating sudden traffic bursts and endurance tests (8-24 hours) for memory leak detection
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 Correlate application metrics with load profiles using AppDynamics/HP BSM monitoring hooks
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 Identify bottlenecks at application, database, and infrastructure layers
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 Produce detailed analysis reports with charts, findings, and specific tuning recommendations
 
 
 </li>
 </ul>
 
 Requirements
 
 
 
 <ul>
 <li>
 7+ years of performance engineering experience
 </li>
 <li>
 Expert in JMeter and/or Gatling script development with complex correlation and parameterisation
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 Experience with AppDynamics or equivalent APM tools for server-side diagnostics
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 Strong analytical skills for interpreting response time distributions, throughput curves, and resource utilisation
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 Experience scripting against banking APIs, web services, and payment gateway integrations
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 Familiarity with CI-integrated performance testing (Jenkins pipeline gates)
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 Preferred Certifications: Certified JMeter Professional, Gatling Academy Certified, AppDynamics Specialist
 
 
 </li>
 </ul>
 
 Why Join CodeNinja?
 
 
 
 <ul>
 <li>
 Work on high-impact, flagship banking transformation programs with a Tier-1 Saudi financial institution
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 Be part of a team that's shaping the future of AI-enabled test automation in the MENA region
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 Collaborate with world-class QA professionals across onsite and offsite delivery models
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 Access to continuous upskilling &mdash; certifications, AI/ML tooling, and emerging QA methodologies
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 Competitive compensation with performance-linked incentives and career progression pathways
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 A culture that values technical excellence, ownership, and innovation without bureaucracy
 
 
 </li>
 </ul>
 
 Disclaimer
 
 
 
 This job description outlines the primary responsibilities and qualifications for the role at the time of posting. It is not exhaustive and may evolve in line with business needs and project requirements. CodeNinja reserves the right to modify role scope as the engagement progresses.
 
 
 All candidates will be subject to standard background verification. Onsite positions require compliance with the client's site access, security, and NDA policies. CodeNinja is an equal opportunity employer and welcomes applications from all qualified individuals regardless of background.
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Senior Performance Engineer - JMeter | Gatling | APM

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