EVBV Associates-(5-Jan-26)

Eclat-Health-Solutions-4; Hyderabad; Hybrid; INR 300,000 - 600,000; Full time

Job summary

Eclat-Health-Solutions-4 is looking for candidates to handle responsibilities related to healthcare revenue cycle management. The ideal candidate will verify insurance details, manage authorization requests, and ensure compliance with regulations.

Key skills include excellent communication, analytical abilities, and technical knowledge of payer systems. Work may be office-based or remote, serving US healthcare clients from India.

Qualifications

• Experience with the Revenue Cycle Management process is crucial.
• Excellent verbal and written English.
• Good attention to detail and problem-solving.
• Familiarity with payer portals, softphones, MS Office, and sometimes EDI transactions (270/271).
• Understanding of insurance plans, authorization processes, and denial management.

Responsibilities

• Using payer websites, IVR, or direct calls to confirm patient eligibility and benefits.
• Documenting specific costs in practice management systems.
• Initiating, tracking, and managing authorization requests for services.
• Maintaining accurate patient and provider information in databases.
• Acting as a communication link between patients, providers, and insurance companies.
• Adhering to SOPs, SLAs, and regulatory guidelines.
• Identifying and escalating discrepancies or complex issues to team leads.

Skills

US Healthcare RCM

Communication

Analytical Skills

Technical

Domain Knowledge

Tools

MS Office

Job description

Responsibilities

• Insurance Verification: Using payer websites, IVR, or direct calls to confirm patient eligibility and benefits.
• Benefit Details: Documenting specific costs like co-pays, deductibles, coinsurance, and coverage limitations in practice management systems.
• Prior Authorization: Initiating, tracking, and managing authorization requests for services.
• Data Management: Maintaining accurate patient and provider information in databases.
• Liaison: Acting as a communication link between patients, providers, and insurance companies.
• Compliance: Adhering to SOPs, SLAs, and regulatory guidelines (like NCQA).
• Escalation: Identifying and escalating discrepancies or complex issues to team leads.

Necessary Skills & Experience

• US Healthcare RCM: Experience with the Revenue Cycle Management process is crucial.
• Communication: Excellent verbal and written English.
• Analytical Skills: Good attention to detail and problem-solving.
• Technical: Familiarity with payer portals, softphones, MS Office, and sometimes EDI transactions (270/271).
• Domain Knowledge: Understanding of insurance plans, authorization processes, and denial management.

Typical Environment

• Often found in BPO/KPO companies in India serving US healthcare clients.
• Can involve office-based work, sometimes with cab facilities, or remote setups.