Medical Claims Specialist

2 days ago


Surat, Gujarat, India beBeeClaims Full time ₹ 8,00,000 - ₹ 12,00,000
Job Title: Medical Claims Specialist

We are seeking a skilled and experienced professional to support our operations by verifying insurance benefits, obtaining prior authorizations, and explaining co-pays, deductibles, and co-insurance to patients. This role is crucial for the success of our sleep studies and DME services.

Key Responsibilities:
  • Verify patient insurance eligibility and benefits for sleep studies, DME, and related procedures.
  • Efficiently obtain prior authorizations from various insurance plans, including HMO and PPO.
  • Clearly communicate with patients regarding their financial obligations, including co-pays, deductibles, and co-insurance.
  • Work effectively with our front office and billing teams to ensure seamless operations.
  • Handle high call volumes with exceptional phone etiquette and attention to detail.
Requirements:
  • Minimum 2 years of experience in medical claims verification and prior authorization.
  • Strong knowledge of insurance plans, including HMO and PPO, as well as co-pays, deductibles, and co-insurance.
  • Familiarity with sleep studies and DME services is an asset.
  • Excellent verbal and written communication skills, with ability to multitask and work independently.
  • Proficiency in EMR systems and Microsoft Office, particularly Excel.
  • Strong team player with a positive attitude and proactive approach.


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