Eligibility Verification

3 days ago

Mohali Punjab, India PAMM INFOTECH PVT LTD Full time

The Eligibility Verification & Authorization Specialist is responsible for verifying patient insurance coverage, determining eligibility for services, and securing prior authorizations and referrals as required by insurance carriers. This role plays a vital part in ensuring patients receive timely care and that services are reimbursed accurately by payers.

**Key Responsibilities**:

- Verify patient insurance coverage and eligibility via online payer portals or by contacting insurance carriers directly.
- Obtain prior authorizations for procedures, and specialist visits as required.
- Proactively follow up with insurance companies on pending authorizations and denials.
- Maintain knowledge of payer-specific guidelines, medical necessity requirements, and authorization procedures.
- Work closely with the billing team to ensure accurate claim submission and reduce denials.
- Ensure compliance with HIPAA and other applicable regulations in all communications.

**Job Types**: Full-time, Permanent

Pay: ₹25,000.00 - ₹35,000.00 per month

**Benefits**:

- Commuter assistance
- Food provided

**Experience**:

- Verification & Authorization: 1 year (preferred)

Work Location: In person

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