Eligibility Verification Specialist

ASP-RCM Solutions; Chennai District; On-site; INR 350,000 - 600,000; Full time

Job summary

ASP-RCM Solutions in Chennai, India seeks a diligent Eligibility Verifier to confirm patient coverage and benefits before care delivery. You will manage exception handling and authorization flagging, ensuring accurate benefit detail capture and robust denial prevention in a high-volume environment.

The role requires comfort with US payer portals, reading 271 responses, and maintaining accuracy under volume.

Qualifications

• Must have strong command of RCM metrics (net collection rate, days in AR, AR >90, denial rate, first-pass resolution, clean claim rate, cost to collect).
• Two+ years in US healthcare eligibility and benefit verification.
• Comfort reading a 271 response and interpreting benefit detail.
• Experience with US payer portals and phone verification.

Responsibilities

• Verify coverage and benefits before care is delivered.
• Handle exception cases escalated by the eligibility engine.
• Flag authorizations and capture benefit details.
• Contribute to front-end denial prevention and documentation.

Skills

RCM metrics

US healthcare eligibility

benefit verification

271/272 reading

US payer portals

phone verification

accuracy under volume

Tools

Payer portals

Job description

You verify coverage and benefits before care is delivered: active coverage, plan type, benefit limits, copay and deductible, and authorization requirements. Our eligibility engine handles the routine 270/271 traffic; you handle the exceptions it escalates and the payers that need a human. Eligibility errors are the single most preventable denial category, and preventing them is the job.

What you will own:

• Accurate verification
• Exception handling
• Authorization flagging
• Benefit detail capture
• Front-end denial prevention
• Documentation

What we look for:

• MANDATORY: working command of RCM metrics, net collection rate, days in AR, AR over 90, denial rate, first-pass resolution rate, clean claim rate and cost to collect
• Two or more years in US healthcare eligibility and benefit verification
• Comfortable reading a 271 response and interpreting benefit detail
• Experience with US payer portals and phone verification
• Accuracy discipline under volume