Eligibility & Benefits Verification Executive

Spruce Lifeskills; Nagpur District; On-site; INR 150,000 - 210,000; Full time

Job summary

Kayal Health is seeking an Eligibility & Benefits Verification Executive to confirm US patient insurance eligibility and benefits. The role focuses on accurate coverage data to reduce claim denials and prevent payment delays.

You will verify eligibility through payer portals and calls, document details in EHR, and communicate issues to the care team, while adhering to HIPAA and client SOPs. Night shift work may be required.

Qualifications

• The poster does not mention a specific educational qualification or experience requirement.
• Preferred skills include understanding US healthcare/insurance processes, strong communication, basic computer/documentation skills, night shift ability, and high attention to detail.

Responsibilities

• Verify patient eligibility through payer portals, IVR and calls.
• Confirm active insurance coverage, copay, deductible, coinsurance and out-of-pocket benefits.
• Verify in-network / out-of-network status and service-specific benefits.
• Identify prior authorization and referral requirements.
• Verify primary, secondary and COB-related issues.
• Document verification details in EHR / Practice Management systems.
• Communicate coverage issues and patient responsibility to the appropriate team.
• Follow client SOPs and HIPAA requirements.
• Maintain required productivity, accuracy and turnaround-time standards.

Skills

US Healthcare

Communication

Computer literacy

Night shift

Attention to detail

Tools

EHR Systems

Practice Management

Job description

US Healthcare / Medical Billing / Insurance Verification / RCM

Eligibility & Benefits Verification Executive

Not Mentioned in the Advertisement Salary: As per company standards / Based on skills & experience

About the Role Kayal Health is looking for an Eligibility & Benefits Verification Executive to verify patient insurance eligibility and benefits for US Healthcare clients. The role focuses on ensuring accurate insurance coverage information, reducing claim denials and preventing payment delays.

Key Responsibilities Verify patient eligibility through payer portals, IVR and calls. Confirm active insurance coverage, copay, deductible, coinsurance and out-of-pocket benefits. Verify in-network / out-of-network status and service-specific benefits. Identify prior authorization and referral requirements. Verify primary, secondary and COB-related issues. Accurately document verification details in EHR / Practice Management systems. Communicate coverage issues and patient responsibility to the appropriate team. Follow client SOPs and HIPAA requirements. Maintain required productivity, accuracy and turnaround-time standards.

Eligibility The poster does not mention a specific educational qualification or experience requirement. Candidates should therefore be evaluated based on the company\'s actual recruitment criteria.

Preferred Skills: Understanding of US Healthcare / Insurance processes. Good communication skills. Basic computer and documentation skills. Ability to work in a US/night shift. Attention to detail and accuracy.

Hiring Company Kayal Health