Join Our Team

1. Insurance Eligibility Verification

• Verify patient insurance eligibility prior to services rendered
• Confirm policy status (active/inactive), effective dates, and coverage limits
• Validate primary, secondary, and tertiary insurance details

2. Benefits & Coverage Review

• Review covered and non-covered services based on patient’s insurance plan
• Identify patient financial responsibility including copay, coinsurance, and deductibles
• Verify coverage for procedures, diagnostics, surgeries, and specialty services

3. Authorization & Referral Support

• Identify services requiring prior authorization or referrals
• Initiate and follow up on authorization requests with insurance providers or TPAs
• Document authorization numbers and validity periods accurately

4. Communication & Coordination

• Communicate verified benefits clearly to patients, front desk, billing, and clinical teams
• Explain insurance benefits and patient responsibility in a simple and professional manner
• Coordinate with physicians and schedulers to avoid service delays

5. Documentation & Data Entry

• Accurately document verification details in the billing system or HIS
• Upload and maintain insurance cards, authorization forms, and verification notes
• Ensure all records are complete, accurate, and audit-ready

6. Compliance & Accuracy

• Ensure compliance with payer guidelines, HIPAA, and organizational policies
• Follow standard operating procedures (SOPs) for benefits verification
• Maintain high accuracy to reduce claim denials and rework

7. Denial Prevention & Follow-up

• Identify potential coverage issues proactively to prevent claim denials
• Escalate discrepancies or unclear benefits to supervisors or payer representatives
• Assist in resolving eligibility-related denials when required

8. Reporting & Quality Monitoring

• Prepare daily and weekly verification reports
• Track turnaround time (TAT), accuracy rates, and error trends
• Participate in quality audits and continuous process improvements

9. Customer Service & Professional Conduct

• Maintain professionalism while interacting with patients and insurance representatives
• Handle sensitive financial and insurance discussions with confidentiality and empathy
• Demonstrate accountability and attention to detail at all times

Educational Qualification

•  Graduate or Undergraduate in any discipline
• Diploma or certification in Medical Billing / Medical Coding / Healthcare Administration is an added advantage

Experience

•  0–3 years of experience in Benefits Verification, Eligibility Verification, or Insurance Coordination
•  Experience in US healthcare RCM is preferred
• Freshers with relevant RCM training may be considered

Core Knowledge & Skills

• Strong understanding of insurance eligibility and benefits verification processes
• Knowledge of copay, coinsurance, deductible, out-of-pocket maximums
• Familiarity with prior authorization and referral requirements
• Basic understanding of claim lifecycle and denial management

Technical Skills

• Experience working with payer portals and insurance IVR systems
• Proficiency in RCM software, HIS, or billing systems
• Working knowledge of MS Excel, Word, and email communication

Communication Skills

• Good verbal and written communication skills
• Ability to explain insurance benefits clearly to internal teams or patients

Behavioral & Professional Attributes

• High attention to detail and accuracy-oriented mindset
• Ability to work under pressure and meet strict TATs
• Strong problem-solving and analytical skills
• Accountability, adaptability, and willingness to learn

Compliance & Ethics

• Understanding of HIPAA compliance and data privacy standards
• Commitment to follow SOPs, payer guidelines, and organizational policies

Productivity & Work Requirements

• Ability to handle high-volume verification work
• Willingness to work in US shifts / rotational shifts, if required
• Capable of meeting productivity and quality benchmarks consistently

Preferred / Added Advantages

• Experience with commercial, Medicare, and Medicaid plans
•  Exposure to TPA coordination and authorization workflows
• Prior experience in denial prevention or front-end RCM processes

• Excellent working atmosphere
• Salary and bonus always paid on-time
• You work for a company that has continuously grown for past 19+ years
• Very supportive senior management
• And lots more