Eligibility & Verification

Job Title: Eligibility and Verification Specialist – Revenue Cycle Management (RCM)Job Summary:

The Eligibility and Verification Specialist is responsible for verifying patients' insurance coverage and eligibility prior to scheduled services. This position ensures that all necessary information is accurate and up-to-date to facilitate correct billing and minimize claim denials.

Key Responsibilities:

• Verify insurance eligibility and benefits for scheduled services, including outpatient, inpatient, and diagnostic procedures.
• Confirm patient coverage, co-pays, deductibles, co-insurance, referral, and authorization requirements.
• Contact insurance companies via portals, phone, or payer tools to confirm details.
• Update patient records with verified insurance and benefit information in the electronic health record (EHR) or practice management system.
• Notify clinical or billing teams of any issues or discrepancies with patient coverage.
• Work closely with front office, billing, and scheduling departments to ensure timely verification.
• Maintain compliance with HIPAA and other healthcare regulations.
• Assist with troubleshooting denied claims related to eligibility or authorization issues.
• Document verification processes and communications thoroughly and accurately.

Please share your resume to ssangar@scale-healthcare.in

Job Type: Full-time

Pay: ₹200,000.00 - ₹400,000.00 per year

Work Location: In person