Job Description

Key Responsibilities

Insurance Verification and Authorization:

• Verify patients' insurance coverage and eligibility for medical services.
• Obtain prior authorizations or pre-certifications for procedures, hospital admissions, and specialty services as required.
• Maintain accurate records of insurance verification and approvals.

Claims Processing and Billing:

• Work closely with the billing department, case management team, and healthcare providers to streamline processes.
• Coordinate the submission of insurance claims and follow up on outstanding claims.
• Review claims for accuracy and compliance with insurance policies.
• Serve as a point of contact for insurance representatives regarding claims and contracts.
• Resolve denials or discrepancies with insurance companies to expedite reimbursements.

Patient Interaction:

• Explain insurance benefits, coverage details, and out-of-pocket costs to patients.
• Assist patients with completing insurance-related paperwork.
• Address patient inquiries and concerns regarding billing and insurance.

Qualifications

Education:

• High school diploma or equivalent (required).
• Associate's or Bachelor's degree in healthcare administration, business, or a related field (preferred).
• Familiarity with insurance verification, claims processing, and coding (CPT, ICD-10).

Skills:

• Excellent communication, organizational, and problem-solving skills.
• Requires extended periods of sitting, data entry, and interaction with patients and insurance representatives.
• Attention to detail and ability to handle confidential information.

Key Performance Indicators (KPIs):

• Timely verification of insurance coverage and pre-authorizations.
• Reduced claim rejection rates.
• High patient satisfaction with insurance and billing support.
• Effective resolution of denied claims within set timelines.

Job Types: Full-time, Permanent

Pay: ?8,086.00 - ?13,000.00 per month

Benefits:

• Health insurance
• Provident Fund

Schedule:

• Day shift
• Fixed shift

Experience:

• total work: 1 year (Preferred)

Work Location: In person