Associate – Eligibility and Authorization
We are seeking a detail-oriented and highly motivated Associate with eligibility and Authorization to join our team. This role involves verifying patient eligibility and obtaining prior authorizations for medical procedures and services. The ideal candidate will have a strong understanding of healthcare insurance plans and be proficient in using various healthcare software systems.
Department: AR
Project Location(s): Hyderabad, TS, India
Education: Any Graduate
Compensation: Up to 4 Lakh per annum
Responsibilities
- Verify patient eligibility and benefits with insurance carriers.
- Determine coverage levels, deductibles, and co-payments.
- Identify and resolve eligibility issues promptly.
- Obtain prior authorizations for medical procedures and services.
- Prepare and submit accurate and timely prior authorization requests.
- Follow up on pending authorization requests and resolve denials.
- Accurately enter patient information, insurance details, and authorization information into the system.
- Maintain accurate and up-to-date patient records.
- Effectively communicate with patients, healthcare providers, and insurance carriers.
- Address inquiries and concerns in a timely and professional manner.
- Adhere to all HIPAA regulations and company policies and procedures.
- Stay updated on industry regulations and guidelines.
Skills/Experience
- 1-2 years of experience in healthcare insurance or a related field.
- Strong understanding of healthcare insurance plans, including Medicare, Medicaid, and commercial insurance.
- Proficiency in Microsoft Office Suite, especially Excel.
- Excellent communication and interpersonal skills.
- Strong attention to detail and accuracy.
- Ability to work independently and as part of a team.
- Willingness to work night shifts and from the office.
To Apply:
If you are a highly motivated individual with a passion for healthcare and a keen eye for detail, we encourage you to apply.