Virtual Healthcare Assistant: Eligibility & Scheduling

Edge; Pakistan; Remote; PKR 11,631,000 - 18,001,000; Full time

Job summary

Edge is seeking a Virtual Healthcare Assistant to support US-based healthcare providers. The role centers on eligibility checks, benefits verification, prior authorizations, and insurance coordination to ensure patients receive timely care.

The ideal candidate has experience with US insurance concepts and healthcare portals, and can navigate EHR systems while maintaining meticulous records and clear communication.

Qualifications

• 1+ year direct experience in US Healthcare (scheduling, eligibility, prior authorizations, insurance verification).
• Strong understanding of US insurance concepts (PPO, HMO, EOBs, copays).
• Proficient navigating insurance portals and EHR/practice management systems.
• Excellent written and verbal English; able to work independently in a fast-paced environment.

Responsibilities

• Conduct eligibility checking and benefits verification for patients prior to appointments.
• Interpret insurance policies (PPO, HMO, Medicare/Medicaid) for patient understanding.
• Determine patient financial responsibilities (deductibles, copays, coinsurance) and document results.
• Prepare and submit prior authorization requests via portals, fax, or phone.
• Review clinical documentation to ensure medical necessity before submission.
• Track pending authorizations, handle appeals for denied claims, expedite urgent requests.
• Handle inbound/outbound calls to schedule, reschedule, and remind patients.

Skills

US Healthcare experience

Scheduling

Eligibility verification

Prior authorizations

Insurance verification

English communication

Tools

Availity

Optum

CoverMyMeds

ECW

Tebra

Dentrix

Job description

Edge is seeking a Virtual Healthcare Assistant to support US-based healthcare providers. The role centers on eligibility checks, benefits verification, prior authorizations, and insurance coordination to ensure patients receive timely care.

The ideal candidate has experience with US insurance concepts and healthcare portals, and can navigate EHR systems while maintaining meticulous records and clear communication.