Insurance Verification Specialist
Location
Bangalore | India
Job description
Description
Maintains patient demographic information and data collection systems. Make necessary updates to each chart to reflect accurate and current information.
- Review patient's medical history and insurance coverage for approval.
- Verify insurance eligibility for medical insurances for upcoming appointments by utilizing online websites or by contacting the carriers directly, for each patient in both locations.
- Verify Commercial plans for coverage and eligibility for both office locations.
- Complete verification form by obtaining the information listed on the form for every Commercial payer.
- Review patient deductibles and/or copays and enter the information in the billing system, share with the Front and Billing Department at all locations.
- Leave Memos and Notes to communicate changes in Eligibility, Coverage, Carrier, and Amounts Due.
- Obtain prior authorization for any Commercial plans that require certain drugs, treatments, and procedures before the service is rendered.
- Complete Online authorizations and referrals for services, including appointments and procedures, by using various online portals for each carrier, by reviewing each medical chart for ordered services by each provider.
- Obtaining referrals for patients when they are not covered.
- Submitting Outbound Referrals for patients who need to see other specialists.
- Coordinate with Billing Manager regarding scheduling errors, such as duplicate appointments and conflicting service requests. MUST NOTIFY Billing Manager when there are denials for referrals and authorization requests.
- Upload approved and denied referrals and authorization requests
- Answers questions from clerical staff, billing department and insurance companies regarding requested services.
- Works in conjunction with the reception and billing department to ensure clean billing.
- Participates in educational activities and attends monthly staff meetings.
- Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
About Encora: Encora, a product engineering and services company provides unmatched opportunities for professional development, benefits, total rewards, and an extraordinary caring culture. It's a Warburg Pincus portfolio company with 20+ offices/ innovation labs and 9000 talent strength worldwide. Encora works across domains like:
- FinTech
- HealthTech
- Security
- Logistics & Supply Chain Security
- Logistics & Supply Chain
- Digital Commerce
- Travel & Hospitality
- Real Estate
- LendTech.
Encorians find a wide range of opportunities to grow with us, whether it is hands-on experience on high impact challenging projects, learning about top technologies, or helping others by sharing what they knowWe have long been recognized as a Great Place to Work. We strive to create an inclusive, caring culture in which people with diverse backgrounds and talents can be their absolute best
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