Insurance Verification Specialist

• Responsible for researching patient member benefits, additional coverages, coverage limitations, and general coverage allowances to obtain the necessary authorizations and referrals for patient services.
• Initiate and manage the prior authorization process for medical procedures, treatments, or medications.
• Prepare and submit prior authorization requests to insurance companies or healthcare payers according to established procedures.
• Ensure all required documentation, including clinical notes, medical history, and supporting documents, are complete and accurate.
• Processes prior authorizations and referral requests in a timely manner, prior to the patient’s services being rendered.
  

Job Requirement

• Bachelor’s degree in any discipline.
• Min 1 year experience in Pre-Authorization & eligibility, benefits
• Strong knowledge of medical terminology, insurance policies, and healthcare reimbursement processes.
• Excellent communication, organizational, and problem-solving skills.
• Ability to work independently and collaboratively in a fast-paced, deadline-driven environment.
• eClinicalWorks experience will be an added advantage.
• Willing to work the night shift (any 9 hrs. between 6:30 pm 3:30 am)
• Salary: as per company policy