VOB & Eligibility Specialist – US Medical Billing

Position: VOB & Eligibility Specialist
Department: Revenue Cycle Management
Location: (On-site)
Shift: US Shift (Night Shift)

Role Summary

The VOB & Eligibility Specialist is responsible for verifying insurance benefits, checking patient eligibility, and ensuring all required information is accurate before services are rendered or claims are submitted. This role plays a critical part in reducing denials, improving cash flow, and ensuring seamless operations within the Revenue Cycle Management process.

Key Responsibilities

• Verify patient insurance coverage using payer portals, IVR, and direct communication with insurance carriers.
• Confirm eligibility status, policy details, copays, deductibles, co-insurance, out-of-pocket limits, and benefit maximums.
• Check coverage limitations, plan benefits, and authorization requirements for specific services.
• Validate patient demographics and update billing systems/EMR with accurate insurance details.
• Identify and resolve issues related to inactive policies, plan changes, or benefit discrepancies.
• Document all findings clearly and ensure timely completion as per client-specific TAT.
• Coordinate with billing, coding, front-office, and prior authorization teams to resolve eligibility or benefit concerns.
• Maintain and apply up-to-date knowledge of insurance guidelines, payer rules, and benefit structures for Medicare, Medicaid, and commercial plans.
• Contribute to reducing claim denials related to eligibility and benefit errors.

Required Skills & Qualifications

Bachelor’s degree is mandatory.

• Minimum 1–2 years of experience in US Medical Billing (VOB and Eligibility preferred).
• Strong understanding of commercial and government payers (PPO, HMO, Medicare, Medicaid, Workers Comp).
• Excellent communication skills—both verbal and written.
• High attention to detail, accuracy, and analytical ability.
• Experience working with EMR/EHR platforms, clearinghouses, and payer portals.
• Ability to meet productivity and quality metrics consistently.
• Willingness to work US night shifts.

Job Type: Full-time

Work Location: In person