We are seeking a detail-oriented and reliable Patient Eligibility Specialist to join our revenue cycle team. This role is crucial in ensuring accurate insurance verification, coordinating patient benefits, and supporting accurate billing. Your efforts will help minimize claim denials and enhance the overall patient experience through clear, proactive communication and process efficiency.
Key ResponsibilitiesInsurance Verification & Eligibility
- Verify insurance coverage via payer portals and direct communication with insurance providers.
- Accurately record eligibility and benefits information in the electronic health records system (eCW).
- Complete and upload eligibility verification forms for new patients in a timely manner.
- Estimate and communicate patients' out-of-pocket costs based on plan benefits.
- Assign follow-up tasks for unpaid balances to the patient collections team.
- Contact patients to collect missing insurance information and ensure all records are up to date.
Authorizations & Compliance
- Obtain prior authorizations for services not immediately covered under insurance.
- Ensure full compliance with Medicaid regulations and payer-specific billing guidelines.
- Identify out-of-network scenarios and coordinate with the patient services team to address them.
- Secure authorizations for psychological testing, update billing alerts, and upload related documents.
Operational Efficiency & Collaboration
- Allocate time daily to manage add-on appointments, supporting efficient provider scheduling.
- Flag billing issues, new insurance policies, or provider network discrepancies for management review.
- Work closely with the practice manager to resolve missing or incomplete patient intake documentation.
- Participate in regular team meetings with the billing manager to improve verification processes and workflow accuracy.
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