insurance verification specialist

Macrise Tech Solutions

We are seeking a highly organized and proactive Insurance Verification &amp; Authorization Specialist to join our medical billing team. This position is responsible for verifying patient insurance coverage, securing prior authorizations, and maintaining accurate records to support smooth billing and claims processing. The ideal candidate will have strong communication skills, attention to detail, and a solid understanding of payer guidelines, with the ability to perform efficiently in a fast-paced healthcare setting.Key ResponsibilitiesInsurance Verification &amp; Eligibility<ul><li>Verify patient insurance benefits through payer portals and direct communication with insurance representatives.</li><li>Accurately update and maintain eligibility details within the Electronic Health Record (EHR) system (e.g., eClinicalWorks).</li><li>Complete and upload insurance verification documentation promptly for new patients.</li><li>Clearly communicate estimated out-of-pocket costs to patients.</li><li>Escalate unresolved coverage or financial concerns to the Patient Collections team.</li><li>Follow up with patients to obtain missing or updated insurance information in a timely manner.</li></ul>Authorizations &amp; Compliance<ul><li>Obtain prior authorizations for services that require insurance approval.</li><li>Ensure compliance with Medicaid and other payer-specific authorization rules.</li><li>Coordinate with the Patient Services team to manage out-of-network insurance cases.</li><li>Secure authorizations for psychological evaluations and maintain accurate documentation and system alerts.</li></ul>Operational Support &amp; Coordination<ul><li>Assist with same-day or urgent appointment scheduling when necessary.</li><li>Report payer policy updates, billing discrepancies, and changes in provider network status.</li><li>Work with the Practice Manager to resolve incomplete patient intake files.</li><li>Participate in recurring team meetings to improve processes, ensure data accuracy, and enhance operational efficiency.</li></ul>Job Type: Full-timePay: Rs40,000.00 - Rs70,000.00 per monthAbility to commute/relocate:<ul><li>Lahore: Reliably commute or planning to relocate before starting work (Required)</li></ul>Application Question(s):<ul><li>Willing to work the night shift?</li></ul>Experience:<ul><li>Medical Billing: 1 year (Preferred)</li></ul>Language:<ul><li>English (Required)</li></ul>Work Location: In person

Insurance Verification Executive-Medical Billing

Anodyne

Documentation Procurement SpecialistPosition SummaryThe Document Procurement Specialist is responsible for obtaining, tracking, and validating all required medical documentation necessary to ensure compliance with Medicare and other insurance carrier requirements for orthotics and orthopedic footwear coverage. This position serves as a liaison between patients, physicians, and internal departments to ensure all clinical documentation&mdash;such as prescriptions, prior authorizations, chart notes, and supporting medical records&mdash;is received in full, accurate, and timely fashion.Key Responsibilities<ul><li>Contact physicians&rsquo; offices, clinics, and patients to request missing or incomplete medical documentation required for coverage approval.</li><li>Follow up on outstanding documentation, maintaining consistent and professional communication until all necessary paperwork is received.</li><li>Verify that all physician documentation meets Medicare and insurance policy criteria (e.g., medical necessity, detailed written orders, prior authorization forms).</li><li>Review received documents for completeness, accuracy, and compliance with regulatory requirements.</li></ul>Patient and Provider Communication<ul><li>Communicate clearly with patients regarding needed forms, signatures, or additional medical information.</li><li>Build and maintain professional relationships with physician offices and support staff to facilitate faster documentation turnaround.</li></ul>Administrative Duties<ul><li>Accurately record and track documentation activity in the internal system such as a documentation tracker.</li><li>Maintain confidentiality of protected health information (PHI) in compliance with HIPAA regulations.</li><li>Collaborate with team members to ensure timely completion of all documentation required before order fulfillment.</li></ul>Qualifications:Education &amp; Experience<ul><li>High school diploma or equivalent required; associate degree preferred.</li><li>1&ndash;3 years of experience in medical documentation, insurance verification, or DME billing preferred.</li><li>Experience working with Medicare and/or Medicaid, is strongly preferred.</li></ul>Skills &amp; Competencies<ul><li>Strong verbal and written communication skills.</li><li>Excellent follow-up and time-management abilities.</li><li>Working knowledge of insurance and medical terminology.</li><li>High attention to detail and accuracy in reviewing clinical documentation.</li><li>Proficiency in Microsoft Office and familiarity with DME management procedures.</li></ul>Physical Demands &amp; Work Environment<ul><li>Standard office environment with frequent computer and phone use.</li><li>Must be able to sit for extended periods and manage multiple tasks in a fast-paced setting.</li></ul>Core Competencies<ul><li>Accountability: Takes ownership of follow-ups and documentation outcomes.</li><li>Compliance Mindset: Adheres to all Medicare and HIPAA regulations.</li><li>Customer Service: Maintains professionalism in all provider and patient communications.</li><li>Organization: Manages multiple requests and tracks documents efficiently.</li></ul>EEO StatementAnodyne is an Equal Employment Opportunity employer. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.Job Type: Full-timePay: From $18.00 per hourExpected hours: 40 per weekBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Employee discount</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off</li><li>Referral program</li><li>Vision insurance</li></ul>Work Location: In person

Document Procurement Specialist - On Site

AdaptHealth

<div>Description:

Position Summary:
The Operations Specialist is responsible for supporting the Operations Team through multiple tasks required for the successful support of each region&rsquo;s individual needs.
Essential Functions and Job Responsibilities:<ul><li>
Supports operations team with discovery and training as necessary with AdaptHealth processes.</li><li>
Responsible for providing support during process improvement initiatives to assist with driving all areas of workflow, including verification, and data analysis.</li><li>
Develop and maintain working knowledge of current products and services offered by the company</li><li>
Must be familiar with payer guidelines and reading clinical documentation to determine qualification status and compliance for all equipment and services.</li><li>
Working knowledge in all areas of AdaptHealth customer service, intake, daily operations and revenue cycle processes and workflows from beginning to end, which may include</li></ul><ul><li>
Review all required documentation to ensure accuracy</li><li>
Accurately process, verify, and/or submit documentation</li><li>
Complete insurance verification to determine patient&rsquo;s eligibility, coverage, co-insurances, and deductibles</li><li>
Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval and authorization when required (if helping a region)</li><li>
Navigate through multiple online EMR systems to obtain applicable documentation</li><li>
Enter and review all pertinent information in EMR system including authorizations and expiration dates</li><li>
Meet quality assurance requirements and other key performance metrics</li></ul><ul><li>
Pays attention to detail and has great organizational skills</li><li>
Actively listens to teams, region leaders and handle stressful situations with compassion and empathy.</li><li>
Ability to analyze data and reports to identify execution errors in workflow, troubleshoot and fix the exceptions, advise staff on corrections.</li><li>
Collaborate with the Operations Team on exceptions and solutions within workflow processes</li><li>
Communicate with operations teams and leadership on an on-going basis regarding any noticed trends in process errors with insurance companies</li><li>
Assist with various projects and tasks as needed for various unique processes</li><li>
Participate in the effort to define, document, and refine processes, procedures and workflows for business operations based on industry and company best-practices.</li><li>
Participate in the effort to create training materials and train client engagement and service teams</li><li>
Maintain patient confidentiality and function within the guidelines of HIPAA.</li><li>
Completes assigned compliance training and other educational programs as required.</li><li>
Maintains compliant with AdaptHealth&rsquo;s Compliance Program.</li><li>
Perform other related duties as assigned.</li></ul>
Competency, Skills and Abilities:<ul><li>
Excellent ability to communicate both verbally and in writing</li><li>
Ability to prioritize and manage multiple tasks</li><li>
Proficient computer skills and knowledge of Microsoft Office</li><li>
Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction</li><li>
General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred.</li><li>
Work well independently and as part of a group</li><li>
Ability to adapt and be flexible in a rapidly changing environment, be patient, accountable, proactive, take initiative and work effectively on a team</li></ul>
Requirements:

Education and Experience Requirements:<ul><li>
High School Diploma or equivalency</li><li>
Three (3) years&rsquo; work related in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry is required.</li></ul>
Physical Demands and Work Environment:<ul><li>
Work environment will be stressful at times, as overall office activities and work levels fluctuate</li><li>
Must be able to bend, stoop, stretch, stand, and sit for extended periods of time</li><li>
Subject to long periods of sitting and exposure to computer screen</li><li>
Ability to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use</li><li>
Excellent ability to communicate both verbally and in writing</li><li>
Ability to effectively communicate both verbally and written with internal and external customers with the ability to demonstrate empathy, compassion, courtesy, and respect for privacy.</li><li>
Mental alertness to perform the essential functions of position.</li></ul></div>

Operations Specialist

Three percent Pakistan

Job Title: Auto Insurance Verifier Company: Nexline BPO (Powered by RCMBS) Location: Opposite PMTAC Building, Behind Malkabad Plaza, 6th Road, Satellite Town, Rawalpindi Contact: 0340-0747852 Job DescriptionNexline BPO (Powered by RCMBS) is hiring Auto Insurance Verifiers for its Rawalpindi office. We are looking for energetic, punctual, and committed individuals who can work in a fast-paced US-based insurance process.As an Auto Insurance Verifier, your role will be to verify customer details, update insurance information, and ensure data accuracy for clients in the US. Training will be provided.Key Responsibilities<ul><li>Make outbound calls for auto insurance verification</li><li>Confirm customer information (name, address, vehicle details, insurance status)</li><li>Maintain accurate and updated record of verified data</li><li>Follow scripts and compliance guidelines</li><li>Coordinate with team leads for quality requirements</li><li>Meet daily/weekly verification targets</li><li>Ensure professionalism in all client interactions</li></ul>Requirements<ul><li>Minimum education: Intermediate (FA/FSc/ICS)</li><li>Good English listening &amp; speaking skills</li><li>Basic computer knowledge</li><li>Confident communication over the phone</li><li>Ability to work night shift for US timings</li><li>Previous call center experience atleast 6 months</li></ul>Shift &amp; Timings<ul><li>Night Shift</li><li>Monday to Friday</li><li>6pm-4am</li></ul>Apply Now For job details or interview scheduling, contact: 0340-0747852Job Type: Full-timePay: Rs25,000.00 - Rs35,000.00 per monthWork Location: In person

Auto Insurance Verifiers

Ironwood Cancer & Research Centers

<div><div><div><div><div><div><div>Ironwood Cancer &amp; Research Centers has beautiful state-of-the-art integrated Cancer and Women's Centers, with locations strategically located throughout the Valley. Each one provides a superior cancer care environment with a full spectrum of cancer related services for patients. Our multi-disciplinary team approach includes surgical oncology, medical oncology, radiation oncology, women's centers, diagnostic imaging services, social service support, nutritionist, integrative services, and genetic counseling.
Mission Statement: To serve the community by providing quality, comprehensive cancer care which respects the values and needs of each individual.
Overview: We are currently looking for a qualified and detail oriented Benefits Coordinator. The Coordinator creates the copay log daily to ensure that patients have a clear understanding of what their copays, coinsurance, cost of treatment, OOP may be prior to service. This is a full time position working 40 hours per week, Monday - Friday schedule.
Essential Duties and Responsibilities:<ul><li>
Complete assigned daily log, maintaining 7 days out consistently.</li><li>
Verify insurance deductible and out of pocket accumulations prior to treatment</li><li>
Verify cost of treatments have been generated to be reviewed with the patient.</li><li>
Review notes for accurate cost estimates for each individual treatment plan.</li><li>
Review accounts notes for any pending adjustments or balances that need to be set up or set up on payment plan.</li><li>
Communicates with management regarding treatment concerns and patients benefits.</li><li>
Strong ledger knowledge ability to accurately assess insurance payments and compare to verification for accuracy. Ability to identify correct balances and credits on account</li><li>
Complete cost estimates for CT/PET scans, radiation therapy, chemotherapy and injections, estimating patient responsibility.</li><li>
Verify and/or enroll patients for foundation, copay/card or financial drug assistance programs.</li><li>
Must be able to type and work on a computer.</li><li>
Performs other duties as requested by supervisor, administrator, or physicians</li></ul>
Knowledge and Skills:<ul><li>
Knowledge of all insurance types and benefit structures.</li><li>
Knowledge of Medical Office operations.</li><li>
Knowledge of medical terminology.</li><li>
Knowledge of chemotherapy related drugs, supplies utilized and SNF, LTC and Hospice in relation to insurance benefits is preferred.</li><li>
Knowledge of governmental, legal and regulatory provisions related to collection activities.</li><li>
Knowledge of CPT, ICD-9, ICD-10, HCPCS coding a plus.</li><li>
Knowledge of basic mathematics. Accounting knowledge a must.</li><li>
Attention to detail is required.</li><li>
Able to be in a seated position, talk on the phone, repetitive keyboard usage and clarity of vision at 20 inches or less.</li></ul>
Job Requirements:<ul><li>
Minimum 3 years of medical insurance experience to include knowledge of all insurance types and benefit structures, heavy emphasis on insurance verification.</li><li>
Oncology experience a plus.</li><li>
High School Diploma; additional education preferred.</li></ul>
We offer a competitive salary and a comprehensive benefit package including health insurance, 401K and a caring work environment. We are an E.O.E.
Please visit our website at www.ironwoodcrc.com. &quot;Outsmarting Cancer One Patient at a Time&quot;</div></div></div></div></div></div></div>

Patient Benefits Coordinator

ZH Healthcare

<ul><li>Experienced in AR calling, Denial Management, checking eligibility and Authorization verification.</li><li>Calling Insurance companies on behalf of physicians and carryout further examination on outstanding Accounts Receivables.</li><li>Prioritize unpaid claims for calling according to the length of time it has been outstanding. Call insurance companies directly and convince them to pay the outstanding claims.</li><li>Check the relevance of insurance info offered by the patient. Evaluate unpaid insurance claims.</li><li>Call insurance companies and check on the status of claims and verifying authorization.</li><li>Transfer the outstanding balance to the patient of he/she doesn&rsquo;t have adequate insurance coverage.</li><li>If the claim has already been paid, ask the insurance company for Explanation of Benefits (EOB).</li><li>Make corrections to the claim based on inputs from the insurance company.</li><li>Good organizational skills to implement timely follow-up.</li><li>Willingness to work in night shifts and weekends.</li><li>Excellent verbal and written communication skills.</li><li>Strong reporting skills. Ability to follow established work schedule.</li><li>Ability to follow instructions precisely.</li></ul>Job Types: Full-time, PermanentPay: &#8377;8,086.00 - &#8377;35,000.00 per monthBenefits:<ul><li>Health insurance</li><li>Provident Fund</li><li>Work from home</li></ul>Work Location: Remote

AR Caller

Prime bpo and Telecommunications

Prime BPO is hiring Verifiers for our Final Expense Campaign. The selected candidates will be responsible for verifying U.S. customer information and ensuring accurate record maintenanceKey Responsibilities:<ul><li>Make outbound calls to U.S. customers</li><li>Identify customer needs and offer appropriate medical equipment solutions.</li><li>Maintain accurate call logs and ensure compliance with campaign standards.</li><li>Achieve daily and monthly verification targets.</li></ul>Requirements:<ul><li>Minimum 1 year of experience in a call center</li><li>Fluency in English with a confident and clear accent.</li><li>Strong communication and verification skills.</li><li>Ability to meet performance targets and work night shifts.</li></ul>Interview Timings:Walk-in Interviews: Mon&ndash;Fri | 6:00 PM &ndash; 11:00 PMLocation: First Floor, Plaza 169F, Civic Center, Bahria Town Phase 4.Job Type: Full-timePay: Rs100,000.00 - Rs150,000.00 per monthWork Location: In person

Sales Verifier

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