Insurance Verification Specialist

Shukla Information Solutions Pvt Ltd; Ahmedabad District; On-site; INR 300,000 - 600,000; Full time

Job summary

Shukla Information Solutions Pvt Ltd in India is seeking a Healthcare Biller to manage prior authorizations and referrals for patient services. You will research coverage allowances, prepare and submit requests, and coordinate with payers to secure timely approvals.

The ideal candidate has 1–5 years of RCM medical billing experience, strong medical terminology knowledge, and excellent communication and organizational skills. Night shift availability is required.

Qualifications

• Bachelor's degree required in any discipline.
• 1–5 years of relevant experience in RCM Medical Billing.
• Strong knowledge of medical terminology, insurance policies, and healthcare reimbursement processes.
• Excellent communication, organizational, and problem-solving skills.
• Ability to work independently and collaborativy in a fast-paced, deadline-driven environment.
• eClinicalWorks experience will be an added advantage.
• Willing to work the night shift (any 9 hrs between 6:30 pm and 3:30 am).

Responsibilities

• Research patient member benefits and coverage allowances to obtain authorizations and referrals.
• Initiate and manage prior authorization process for procedures, treatments, or medications.
• Prepare and submit prior authorization requests to insurance payers.
• Ensure all required documentation, including clinical notes and medical history, is complete.
• Process prior authorizations and referral requests timely before services.

Skills

Communication

Organizational skills

Problem solving

Collaboration

Night shift readiness

Education

Bachelor's degree

Tools

eClinicalWorks

Job description

Job Description

• Responsible for researching patient member benefits, additional coverages, coverage limitations, and general coverage allowances to obtain the necessary authorizations and referrals for patient services.
• Initiate and manage the prior authorization process for medical procedures, treatments, or medications.
• Prepare and submit prior authorization requests to insurance companies or healthcare payers according to established procedures.
• Ensure all required documentation, including clinical notes, medical history, and supporting documents, are complete and accurate.
• Processes prior authorizations and referral requests in a timely manner, prior to the patient's services being rendered.

Job Requirement

• Bachelor's degree in any discipline.
• 1 to 5 years of relevant experience Hands-on experience with RCM Medical Billing
• Strong knowledge of medical terminology, insurance policies, and healthcare reimbursement processes.
• Excellent communication, organizational, and problem-solving skills.
• Ability to work independently and collaboratively in a fast-paced, deadline-driven environment.
• eClinicalWorks experience will be an added advantage.
• Willing to work the night shift (any 9 hrs. between 6:30 pm 3:30 am)
• Salary: as per company policy