Eligibility Specialist

Job Description:

We are seeking a detail-oriented and analytical Insurance Verification & Eligibility Specialist to join our Revenue Cycle team. The ideal candidate will be responsible for verifying patient insurance coverage, determining eligibility, obtaining prior authorizations, and ensuring accurate documentation to support timely claim submission and payment. This role is critical in reducing claim denials, accelerating reimbursements, and supporting overall financial performance in a U.S. healthcare environment.

Key Responsibilities
:

Insurance Verification & Eligibility:

• Verify patient insurance coverage (commercial, Medicare, Medicaid, and other payers) prior to appointments or services.
• Confirm benefits, deductibles, co-insurance, co-payments, policy limitations, and exclusions.
• Review and interpret payer portals, EHR systems, and clearinghouses for real-time eligibility updates.
• Ensure accurate documentation o...