2.0 - 6.0 years

0 Lacs

karnataka

On-site

As an experienced professional in end-to-end follow-up and resolution of outstanding patient and insurance balances for U.S. healthcare clients, you will be responsible for delivering accurate, compliant, and timely cash collection. Upholding core principles such as customer-first approach, straightforward communication, respect, humility, and continuous learning will be crucial in your role. Your key responsibilities will include denial management by analyzing EOB/ERA codes, assigning root-cause categories, and recording preventative notes for training and proactive process improvement to reduce denial rate. Additionally, you will handle eligibility & authorization tasks, verify coverage and prior-authorization status before resubmission, and maintain logs for provider feedback. Ensuring a positive patient experience by resolving balance queries within 2 business days via phone/email to maintain a 95% CSAT score will be essential. Compliance & reporting tasks will involve safeguarding PHI per HIPAA, SOC 2, and organizational policies, updating the daily A/R aging dashboard, escalating any >45-day spike to the manager, and completing daily checklists before the close of your shift. To excel in this role, you should hold a graduate degree or diploma in commerce, healthcare administration, or equivalent. Possessing a CPC or CPB certification is preferred. Proficiency in practice management or RCM platforms such as Athena One, Kareo, eClinicalWorks is required. Advanced Excel skills including pivot tables & lookups, basic Power BI or similar dashboard exposure, and familiarity with productivity trackers and generative-AI assistance tools will be beneficial. Being proactive, taking initiative, and being a team player willing to help colleagues are qualities that will contribute to your success. High attention to detail, zero tolerance for posting errors, and effective communication skills in English are essential. Embracing organizational principles in your daily behavior is expected. In terms of the work environment, you will be operating from a dedicated office environment during night shifts to align with U.S. healthcare client timelines. Your commitment to working during night shifts will demonstrate your flexibility and dedication to the role.,

Posted 1 week ago

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Benefit Verification Specialist 100ms Inc

2.0 - 14.0 years

0 - 0 Lacs

karnataka

On-site

About 100ms At 100ms, we are dedicated to developing AI agents that streamline intricate patient access workflows within the U.S. healthcare sector, commencing with benefits verification, prior authorization, and referral intake in specialty pharmacy. Our primary objective is to assist care teams in diminishing delays and administrative burdens, thereby enabling patients to commence treatment promptly. The foundation of our automation platform lies in the amalgamation of profound healthcare expertise with LLM-based agents and a resilient operational framework. You will become an integral part of the specialized healthcare automation team at 100ms, where your role as a Benefits Verification Specialist holds immense significance. With over 14 years of experience in U.S. health insurance eligibility and benefits verification, you will contribute to verifying insurance benefits for patients undergoing specialty care in the United States. This is a full-time position based in Bangalore, requiring partial availability during U.S. hours. Key Responsibilities - Accurately document findings in internal systems. - Collaborate with internal teams to address missing or inconsistent data. - Engage with technology teams to enhance data/systems. - Ensure timely completion of verifications with high precision and adherence to defined SLAs. Requirements - Minimum of 2 years of experience in U.S. healthcare insurance verification. - Proficiency in understanding various insurance types (commercial, Medicare, Medicaid, HMO/PPO, etc.). - Strong attention to detail and adeptness in precise documentation. - Proficient in both written and verbal English communication. Good to Have - Background in specialty pharmacy, oncology, infusion therapy, or behavioral health. - Prior exposure to RCM platforms, EMRs, or AI-driven automation tools. Compensation - Salary: 3.0 - 5.4 LPA (experience-based). - Equity: Up to 0.01%. - Location: Bangalore (on-site). Why Join Us - Contribute to resolving crucial challenges in healthcare automation. - Embrace a high-responsibility role within a startup environment, fostering mentorship and rapid learning. - Collaborate closely with product and engineering teams to develop state-of-the-art AI agents. - Contribute towards enhancing access to care for patients throughout the U.S. Job Type: Full-time Benefits: - Health insurance Work Location: In person,

Posted 3 weeks ago

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