US Healthcare Insurance Claim Specialist

2 days ago


Mumbai Bengaluru Bangalore Hyderabad Secunderabad Telangana, India beBeeInsurance Full time ₹ 9,00,000 - ₹ 12,00,000
Insurance Claim Specialist

This role involves managing insurance claims and ensuring timely resolutions.

Key Responsibilities:
  • Phone insurance companies to follow up on unpaid or denied claims
  • Review claim status, resolve denials or rejections, and escalate unresolved issues
  • Understand insurance guidelines, CPT codes, and denial reason codes
  • Document call details and update the system with proper status
  • Meet daily call volume and productivity targets
Pre-Authorization Executive Role:
  • Verify patient eligibility and insurance benefits
  • Obtain pre-authorizations and prior approvals from insurance companies
  • Follow up with insurance and providers to ensure approvals are received in time
  • Maintain logs and documentation for audits and compliance
  • Coordinate with billing and scheduling teams to ensure timely services
Requirements:
  • Education: Graduate degree (Life Sciences or Healthcare background preferred)
  • Experience:
  • Minimum 6 months to 3 years in AR Calling or Pre-auth in US Healthcare
  • Communication Skills:
  • Excellent verbal communication and listening skills
  • Neutral accent with clarity and confidence
  • Familiarity with US healthcare terminologies and claim cycle
Required Skills:
  • Knowledge of payer portals, insurance processes, and billing workflows
  • Hands-on experience with EHR/RCM systems
  • Strong problem-solving skills and attention to detail
  • Ability to multitask and manage time efficiently
  • Goal-driven, with a focus on collections and approvals turnaround


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