Eligibility and Verification Specialist - Revenue Cycle Management (RCM)
Job Summary:
The Eligibility and Verification Specialist is responsible for verifying patients' insurance coverage and eligibility prior to scheduled services. This position ensures that all necessary information is accurate and up-to-date to facilitate correct billing and minimize claim denials.
Key Responsibilities:
Verify insurance eligibility and benefits for scheduled services, including outpatient, inpatient, and diagnostic procedures.
Confirm patient coverage, co-pays, deductibles, co-insurance, referral, and authorization requirements.
Contact insurance companies via portals, phone, or payer tools to confirm details.
Update patient records with verified insurance and benefit information in the electronic health record (EHR) or practice management system.
Notify clinical or billing teams of any issues or discrepancies with patient coverage.
Work closely with front office, billing, and scheduling departments to ensure timely verification.
Maintain compliance with HIPAA and other healthcare regulations.
Assist with troubleshooting denied claims related to eligibility or authorization issues.
Document verification processes and communications thoroughly and accurately.
Please share your resume to ssangar@scale-healthcare.in
Job Type: Full-time
Pay: ?200,000.00 - ?400,000.00 per year
Work Location: In person
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