Urgent Hiring for Eligibility Executive

6 days ago

Gotri Vadodara Gujarat, India Healthcare Informatics Pvt. Ltd. Full time

**Job Summary**:
The Eligibility Verification Specialist is responsible for verifying patient insurance coverage, ensuring accurate billing and reimbursement, and minimizing claim denials. This role involves communicating with insurance companies, patients, and healthcare providers to gather and verify insurance information.

**Key Responsibilities**:
Insurance Verification:
Verify patient insurance coverage and benefits by contacting insurance companies and using online portals.

Confirm patient eligibility, coverage levels, and any authorization requirements for medical procedures.

Data Entry and Documentation:
Accurately enter and update patient insurance information in the billing system.

Document and maintain records of all verification activities and communications.

Communication:
Communicate with patients to obtain necessary information for insurance verification.

Collaborate with healthcare providers to clarify coverage issues and obtain required authorizations.

Claims Management:
Identify and resolve discrepancies or issues related to insurance coverage.

Assist in the pre-authorization process for specific procedures, if required.

Reporting and Compliance:
Generate reports on verification activities and outcomes.

Ensure compliance with HIPAA regulations and company policies.

Continuous Improvement:
Stay updated on changes in insurance policies and regulations.

Participate in training sessions and team meetings to improve processes and knowledge.

**Qualifications**:
Education: High school diploma or equivalent; Associate's degree in healthcare administration, business, or related field preferred.

Experience: Minimum of 1-2 years of experience in medical billing, insurance verification, or a related field.

**Knowledge**:
Understanding of medical billing processes and terminology.

Familiarity with various insurance plans, including Medicare and Medicaid.

**Skills**:Strong attention to detail and accuracy.

Excellent communication and interpersonal skills.

Proficient in using medical billing software and Microsoft Office Suite.

Ability to work independently and as part of a team.

**Experience**:

- total work: 1 year (preferred)

Work Location: In person

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