Eligibility, Benefits, Auth Submission, and Tracking Specialist

CTB Solutions; Chennai; In loco; INR 240.000 - 420.000; Tempo pieno

Descrizione del lavoro

CTB Solutions in Chennai, India seeks a detail‑oriented healthcare payer verifier to handle eligibility and benefits verification, authorization submission, and ongoing tracking. The role emphasizes accuracy, timely communication with insurers and providers, and strict adherence to regulatory requirements.

You will maintain documentation, support patient services, and collaborate with departments to streamline billing processes in a fast‑paced environment.

Competenze

• Knowledge of medical insurance policies, procedures and terminology.
• Excellent organizational and multitasking abilities.
• Strong communication and customer service skills.
• Proficiency in medical billing software and MS Office Suite.

Mansioni

• Verify patient insurance eligibility and benefits in a timely and accurate manner.
• Verify and document patient benefits information and ensure correct entry in the system.
• Prepare and submit authorization requests and follow up to avoid delays.
• Track authorization statuses and coordinate with providers and insurers to expedite processes.
• Maintain accurate documentation of eligibility, benefits, and authorization activities and ensure compliance with laws and company policies.
• Provide excellent customer service to patients, providers, and insurers and resolve related issues professionally.
• Collaborate with other departments to ensure a seamless billing process and participate in improvement initiatives.

Conoscenze

Insurance knowledge

Organizational skills

Communication skills

Billing software

Formazione

High School Diploma

Associate/Bachelor's in healthcare admin or related

Strumenti

Microsoft Office

Medical billing software

Descrizione del lavoro

Job Responsibilities:

1. Eligibility Verification:

• Verify patient insurance eligibility and benefits in a timely and accurate manner.
• Ensure all necessary documentation is collected and properly communicated to the appropriate personnel.
• Maintain up-to-date knowledge of insurance plans and changes in insurance policies.

2. Benefits Verification:

• Obtain and clarify patient benefits information, and ensure its accurately recorded in the system.
• Communicate with insurance companies to resolve any discrepancies in benefits information.

3. Authorization Submission:

• Prepare, submit, and follow up on authorization requests to insurance companies.
• Ensure that all necessary documentation is submitted accurately and in a timely manner to avoid any delays in authorization.

4. Authorization Tracking:

• Track authorization status and maintain an organized and up-to-date tracking system.
• Communicate with healthcare providers and insurance companies to expedite the authorization process when necessary.

5. Documentation and Compliance:

• Maintain accurate and complete documentation of all eligibility, benefits, and authorization activities.
• Ensure compliance with federal and state laws, as well as company policies and procedures.

6. Customer Service:

• Provide excellent customer service to patients, healthcare providers, and insurance companies.
• Address and resolve any issues or concerns related to eligibility, benefits, and authorization in a professional and timely manner.

7. Team Collaboration:

• Collaborate with other departments to ensure a seamless billing process.
• Participate in team meetings and continuous improvement initiatives to enhance the efficiency and accuracy of the eligibility and authorization processes.

Qualifications:

1. Education:

• High School Diploma required.
• Associate s or Bachelor s degree in healthcare administration, business, or related field preferred.

2. Experience:

• Minimum of 2 years of experience in medical billing, insurance verification, or related field.
• Experience with authorization submission and tracking is highly desirable.

3. Skills:

• Strong knowledge of medical insurance policies, procedures, and terminology.
• Excellent organizational and multitasking skills.
• Strong communication and customer service skills.
• Proficiency in using medical billing software and Microsoft Office Suite.

4. Certifications:

• Certification in Medical Billing or related field is a plus.

5. Other:

• Ability to work independently and as part of a team.
• Attention to detail and ability to work in a fast-paced environment.