Healthcare Insurance Specialist

3 hours ago


Delhi, Delhi, India EVERSANA Full time

At EVERSANA, we are seeking a highly skilled Healthcare Insurance Specialist to join our team.

About the Role:

We offer a competitive salary of ₹600,000 - ₹800,000 per annum, depending on experience.

Job Description:

The Healthcare Insurance Specialist will play a crucial role in verifying patient insurance coverage and benefits, communicating with insurance companies to obtain and confirm patient benefit information, accurately documenting and updating patient benefit information in the system, processing reimbursement claims and ensuring timely follow-up, obtaining prior authorization for medications as required, coordinating with healthcare providers and insurance companies, maintaining detailed records of all authorization requests and outcomes, handling incoming and outgoing phone calls in a professional and courteous manner, providing patients with accurate information regarding their benefits, authorizations, and reimbursements, and addressing patient inquiries and resolving issues promptly.

Key Responsibilities:

  • Benefit Verification: Verify patient insurance coverage and benefits, communicate with insurance companies to obtain and confirm patient benefit information, and accurately document and update patient benefit information in the system.
  • Reimbursement: Assist patients with understanding their reimbursement options, process reimbursement claims, and ensure timely follow-up.
  • Prior Authorization: Obtain prior authorization for medications as required, coordinate with healthcare providers and insurance companies, and maintain detailed records of all authorization requests and outcomes.
  • Phone Calls: Handle incoming and outgoing phone calls in a professional and courteous manner, provide patients with accurate information regarding their benefits, authorizations, and reimbursements, and address patient inquiries and resolve issues promptly.

Requirements:

To be successful in this role, you should have a strong understanding of insurance policies, benefits, and reimbursement processes. You should also be proficient in using healthcare information systems and other relevant software. Additionally, you should have excellent communication skills, both verbal and written, and be able to handle a high volume of phone calls and multitask effectively. Detail-oriented individuals with strong organizational skills and ability to work independently and as part of a team will thrive in this role.



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