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Medical Claims Examiner

3 weeks ago

Bharatpur, Rajasthan, India beBeeInsurance Full time ₹ 9,00,000 - ₹ 12,00,000
Medical Insurance Verification/Prior Authorization Specialist

This role involves verifying insurance benefits and eligibility for medical procedures, as well as obtaining prior authorizations efficiently and accurately.

The ideal candidate will have strong knowledge of co-pays, deductibles, and co-insurance, as well as experience working with various insurance plans including HMO and PPO.

  • Key Responsibilities:
  • Verify insurance benefits and eligibility for sleep studies, DME, and related procedures.
  • Obtain prior authorizations efficiently and accurately.
  • Understand and explain co-pays, deductibles, and co-insurance to patients.
  • Work with various insurance plans including HMO and PPO.
  • Document and track authorizations in EMR systems and Excel.
  • Communicate clearly and professionally with patients and insurance companies.
  • Support front office and billing teams when needed.
  • Handle a high call volume with excellent phone etiquette and attention to detail.
Requirements:
  • Minimum 2 years of experience in medical insurance verification and prior authorization.
  • Strong knowledge of co-pays, deductibles, co-insurance, and insurance plan types.
  • Familiarity with sleep studies and DME services is preferred but not required.
  • Ability to multitask, stay organized, and shift roles when necessary.
  • Excellent verbal and written communication skills.
  • Proficiency in EMR systems and Microsoft Office (especially Excel).
  • Strong team player with a positive and proactive attitude.