Insurance Verification Specialist

Posted Yesterday
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Bangalore, Bengaluru, Karnataka
Senior level
Software • Consulting
The Role
The Insurance Verification Specialist is responsible for maintaining patient data, verifying insurance eligibility, completing authorizations and referrals, and communicating changes to the billing department. This role involves using online resources and direct contact with insurance carriers to ensure accurate patient coverage and payments.
Summary Generated by Built In

Description here:

Important Information

Location: Pan India

Experience: 5+ years

Job Mode: Full-time

Work Mode:Remote

Job Summary:

  • 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

Job Responsibilities:

  • In this role, the candidate will complete authorizations and referrals for the medical services requested by each provider in both office locations.
  •  In addition to reviewing the medical history of potential patients, you verify information provided by their referring physicians and verify their insurance coverage
  • .You will monitor the schedule for our add-on patients, run appointment reports, ensuring there are no conflicts and that we have the prior authorization we need to move forward with their appointment or procedure.
  • Candidates will also be responsible for submitting Outbound authorization requests for patients being referred to other specialists.
  •  Approved authorizations must be uploaded into Electronic Health Record program and added to each patient chart to ensure correct services have been approved.
  •  Authorization Specialist will be responsible for communicating with Billing Department regarding changes in insurance information,
  • Denied authorization requests, conflicting appointments, and service requests for each provider.

About Encora

Encora is the preferred digital engineering and modernization partner of some of the world’s leading enterprises and digital native companies. With over 9,000 experts in 47+ offices and innovation labs worldwide, Encora’s technology practices include Product Engineering & Development, Cloud Services, Quality Engineering, DevSecOps, Data & Analytics, Digital Experience, Cybersecurity, and AI & LLM Engineering.

At Encora, we hire professionals based solely on their skills and qualifications, and do not discriminate based on age, disability, religion, gender, sexual orientation, socioeconomic status, or nationality.


The Company
Chennai
7,456 Employees
Hybrid Workplace
Year Founded: 1980

What We Do

Headquartered in Santa Clara, California, and backed by renowned private equity firms Advent International and Warburg Pincus, Encora is the preferred technology modernization and innovation partner to some of the world’s leading enterprise companies. It provides award-winning digital engineering services including Product Engineering & Development, Cloud Services, Quality Engineering, DevSecOps, Data & Analytics, Digital Experience, Cybersecurity, and AI & LLM Engineering. Encora's deep cluster vertical capabilities extend across diverse industries, including HiTech, Healthcare & Life Sciences, Retail & CPG, Energy & Utilities, Banking Financial Services & Insurance, Travel, Hospitality & Logistics, Telecom & Media, Automotive, and other specialized industries.
With over 9,000 associates in 47+ offices and delivery centers across the U.S., Canada, Latin America, Europe, India, and Southeast Asia, Encora delivers nearshore agility to clients anywhere in the world, coupled with expertise at scale in India. Encora’s Cloud-first, Data-first, AI-first approach enables clients to create differentiated enterprise value through technology

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