Remote US Healthcare Eligibility & Scheduling Specialist

Edge; Pakistan; On-site; PKR 8,886,000 - 14,440,000; Full time

Job summary

Edge seeks a Virtual Healthcare Assistant to support US-based healthcare providers from a remote location. The role involves eligibility checks, benefits verification, prior authorizations, and insurance portals navigation to ensure timely patient access to care.

Ideal candidates have at least 1 year in US healthcare processes, familiarity with PPO/HMO, and strong English communication. You will liaise between patients, providers, and insurers, handling scheduling and documentation in EHR

Qualifications

• 1 year of direct experience in US healthcare scheduling, eligibility, prior authorizations, or verification.
• Deep understanding of PPO, HMO, EOBs and patient benefits eligibility verification.
• Proficiency navigating insurance portals and electronic health record/practice management systems.
• Excellent written and verbal English communication; able to work independently in a fast-paced environment.

Responsibilities

• Check patient eligibility and verify benefits before appointments.
• Interpret insurance policies and determine patient financial responsibilities (deductibles, copays, coinsurance).
• Prepare and submit prior authorization requests via portals, fax, or phone.
• Review clinical docs to ensure medical necessity before submission.
• Track status of authorizations, manage appeals for denied claims, expedite urgent requests.
• Handle calls to schedule, reschedule, and remind patients about wellness visits.

Skills

English proficiency

US healthcare knowledge

Insurance verification

Tools

Availity

Optum

CoverMyMeds

ECW

Tebra

Dentrix

Job description

Edge seeks a Virtual Healthcare Assistant to support US-based healthcare providers from a remote location. The role involves eligibility checks, benefits verification, prior authorizations, and insurance portals navigation to ensure timely patient access to care.

Ideal candidates have at least 1 year in US healthcare processes, familiarity with PPO/HMO, and strong English communication. You will liaise between patients, providers, and insurers, handling scheduling and documentation in EHR