Insurance Claim Resolution Specialist

1 week ago


Chennai Navi Mumbai Hyderabad Secunderabad Telangana, India beBeeAuthorization Full time US$ 80,000 - US$ 1,20,000
Key Responsibilities:
  • Contact insurance companies to follow up on unpaid or denied claims.
  • Analyze EOBs and identify reasons for denials or delays.
  • Take corrective actions based on payer responses.
  • Update billing software with clear notes on call outcomes and claim status.
  • Meet productivity and quality benchmarks.
  • Maintain HIPAA compliance at all times.

 

Required Skills and Qualifications:
  • Strong spoken English skills.
  • Understanding of US healthcare terms and insurance types.
  • Experience in AR calling / denial management preferred.
  • Attention to detail and time management skills.

 

Role: Prior Authorization Executive
  • Initiate and obtain prior authorizations from insurance carriers.
  • Review patient eligibility and benefits through insurance portals and calls.
  • Ensure documentation and clinical notes are submitted accurately.
  • Communicate with healthcare providers and insurance reps to track authorization status.
  • Maintain authorization logs and escalate pending requests.
  • Handle pre-certification and retro-authorization workflows.

 

Requirements:
  • Excellent communication and coordination skills.
  • Basic understanding of insurance verification and medical necessity requirements.
  • Familiarity with EHR systems is a plus.
  • Prior experience in prior auth / eligibility verification is preferred.


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