Verification of Benefits-Medical Billing

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 insurance eligibility verification, securing timely prior authorizations, and maintaining complete documentation to support efficient billing and claims processing. The ideal candidate possesses strong communication skills, exceptional attention to detail, and a solid understanding of payer guidelines, 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 carriers.
• Maintain accurate and up-to-date eligibility records within the Electronic Health Record (EHR) system, such as eClinicalWorks.
• Complete, upload, and document insurance verification information promptly for all new patient registrations.
• Clearly communicate estimated patient financial responsibility, including copays, deductibles, and out-of-pocket expenses.
• Escalate unresolved eligibility discrepancies or coverage issues to the Patient Collections team when necessary.
• Proactively follow up with patients to obtain missing, corrected, or updated insurance information.

Authorizations & Regulatory Compliance

• Obtain prior authorizations for medical and behavioral health services requiring payer approval.
• Ensure compliance with Medicaid and other payer-specific authorization policies and procedures.
• Collaborate 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 when required.
• Monitor and communicate updates related to payer policies, billing issues, and provider network participation.
• Work closely with the Practice Manager to resolve incomplete or inaccurate patient intake documentation.
• Participate in team meetings to improve workflows, enhance data accuracy, and support continuous process improvement initiatives.

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 in the USA time?

Experience:

• Medical Billing: 1 year (Preferred)

Language:

• English (Required)

Work Location: In person