Pre-Registration, VOB & Pre-Authorization Specialist (DME, Lab, & PT Expertise)

For more details you can drop your resume at shweta.dhhal@imarkinfotech.com or call at 977.923.2778

We are seeking a highly experienced and meticulous Pre-Registration, Verification of Benefits (VOB), and Pre-Authorization Specialist to join our US healthcare medical billing team. This critical front-end Revenue Cycle Management (RCM) role requires specialized expertise in managing patient intake for Durable Medical Equipment (DME), Laboratory (Lab), and Physical Therapy (PT) services. The ideal candidate will have a minimum of 4 years of relevant experience, exceptional client handling skills, and proficiency with industry-leading Practice Management Systems (PMS).

Key Responsibilities

• Verification of Benefits (VOB) & Eligibility:
• Conduct thorough and accurate VOB for all incoming DME, Lab, and PT services, contacting commercial, federal (Medicare/Medicaid), and state payers.
• Identify patient financial responsibility (co-pays, deductibles, co-insurance) and communicate this information clearly and professionally to the patient or client.
• Expertise in interpreting complex DME benefits, Lab service carve-outs, and specific visit limits/authorization requirements for Physical Therapy.
• Pre-Authorization/Prior Authorization Management:
• Manage the entire prior authorization lifecycle for complex DME items, high-cost Lab tests, and extended or ongoing PT treatment plans.
• Prepare, submit, and track authorization requests electronically and telephonically, ensuring all required clinical documentation is included to meet payer-specific criteria.
• Proactively follow up on pending authorizations and appeal denials as necessary to prevent service delays or claim rejections.
• Pre-Registration & Patient Intake:
• Complete accurate and timely patient pre-registration, verifying demographic and insurance information in the Practice Management System.
• Coordinate closely with clients and clinical staff to ensure all necessary intake forms and consent documents are obtained prior to service delivery.
• Technical and Administrative Proficiency:
• Utilize and maintain proficiency with Practice Management Systems (PMS) such as NextGen, Tebra, and Brightree for patient intake, VOB, and authorization tracking.
• Prepare detailed VOB/Authorization reports and tracking documents using Microsoft Excel, Word, and PowerPoint.
• Stakeholder Interaction & Collaboration:
• Maintain professional and empathetic communication (client handling) with patients, providers, and clients regarding benefits, authorizations, and financial responsibilities.
• Actively participate in cross-departmental collaboration with credentialing, billing, and clinical teams to ensure a seamless handoff of patient information and authorization data.