Eligibility & Verification

As an Eligibility & Verification Specialist, your role will involve verifying patients" insurance coverage and eligibility for services. You will be responsible for ensuring that all necessary pre-authorization and insurance requirements are met before service delivery to reduce denials and optimize reimbursement. Your attention to detail, excellent communication skills, and solid understanding of insurance processes and regulations will be crucial for success in this role. Key Responsibilities: - Ensure required authorizations or referrals are obtained before services are rendered. - Accurately update insurance information and verification notes in the patient management system. - Collaborate with front desk, billing, and clinical staff to address coverage issues. - Communicate with patients to discuss their insurance coverage and clarify financial responsibilities when necessary. - Monitor and follow up on pending verifications and authorizations. - Identify and escalate complex coverage or authorization issues to supervisors or relevant departments. Qualifications: Required: - High school diploma or GED. - 2+ years of experience in medical insurance verification, eligibility, or a similar role. - Familiarity with commercial, Medicare, Medicaid, and managed care plans. If you are interested in this opportunity, please share your CV with ssangar@scale-healthcare.in or contact us at 8699557349. Note: The job type for this position is Full-time and the work location is In person.,