Eligibility and Verifications Specialist
4 days ago
Summary:
An Eligibility and Verifications Specialist's main responsibility is verifying insurance coverage, estimating patient cost-sharing responsibilities, and determining the coverage of specific services, devices, and treatment modalities under patients' insurance plans. Your expertise will ensure accurate billing, streamline administrative processes, and enhance patient satisfaction. Reports to: Team Lead, Patient Benefits and Eligibility Key Responsibilities:
- Insurance Verification:
- Verify patients' insurance coverage and eligibility through electronic systems or direct communication with insurance providers.
- Review insurance policies, benefit summaries, and pre-authorization requirements to determine coverage for medical services, devices, and treatment modalities.
- Update patient records with verified insurance information and coverage details.
- Cost Estimation:
- Estimate patients' out-of-pocket expenses, including co-pays, deductibles, and co-insurance, for planned medical services or procedures.
- Communicate cost estimates to patients, explaining their financial responsibilities and payment options.
- Coverage Determination:
- Investigate and determine if specific medical services, devices, or treatment modalities are covered under patients' insurance plans.
- Liaise with insurance companies to obtain pre-authorizations and prior approvals for procedures or treatments when necessary.
- Advise healthcare providers and patients on coverage limitations and alternative payment options for non-covered services.
- Documentation and Reporting:
- Maintain accurate records of insurance verifications, coverage determinations, and patient cost estimates.
- Generate reports on insurance verification outcomes, coverage trends, and reimbursement issues to support decision-making and process improvement.
- Collaboration and Communication:
- Collaborate with healthcare providers, billing staff, and administrative personnel to ensure seamless coordination of insurance verification processes.
- Communicate effectively with patients, answering their insurance-related inquiries and providing assistance in understanding their coverage options. Skills Required: Strong verbal and written communication skills Expert understanding of insurance benefits and coverage Understanding of insurance web portals Problem solving minded/focused
Requirements:
Minimum 2 years of experience in an benefits and verification Resolution focused and driven mindset
-
RCM Specialist
4 days ago
General Santos, Soccsksargen, Philippines Virtual Staffing Solutions Full time ₱900,000 - ₱1,200,000 per yearDescriptionWe are looking for a highly organized and detail-oriented Revenue Cycle Management Specialist to join our growing team. This role plays a critical part in ensuring accurate billing, authorization management, and payer compliance. The ideal candidate will have strong analytical skills, at least basic Excel skills, and experience navigating various...
-
outbound inventory specialist
2 weeks ago
General Santos, Soccsksargen, Philippines RELL AND RENN FISHING CORPORATION Full time ₱400,000 - ₱600,000 per yearJOB SUMMARYThe Outbound Inventory Specialist is responsible for preparing, documenting, and dispatching goods in line with sales orders and customer requests. The role ensures accurate order fulfillment, proper coordination with warehouse and finance teams, and timely reporting to support smooth operations.QUALIFICATIONS:Graduate of Accounting, Business...
-
Accounts Receivable Specialist
3 weeks ago
General Santos, Soccsksargen, Philippines New Era Technology Full timeJoin New Era Technology, where People Firstis at the heart of everything we do. With a global team of over 4,500 professionals, we're committed to creating a workplace where everyone feels valued, empowered, and inspired to grow. Our mission is to securely connect people, places, and information with end-to-end technology solutions at scale.At New Era,...
-
Collections and Recovery Supervisor
2 days ago
General Santos, Soccsksargen, Philippines Radiowealth Finance Company Full time ₱900,000 - ₱1,200,000 per yearJob DescriptionResponsible for the credit investigation and collection in a branch in accordance with the company standards to attain company goals and objectives. Process owner in terms of booking, Collection Efficiency, Remedial Management, Real and Property Owned and Acquired Management.Duties and Responsibilities:Sales and MarketingAchieves booking...
-
General Santos, Soccsksargen, Philippines F and J Travel and Tour Full time ₱11,000 - ₱12,500 per yearCampaign Planning and Strategy:Creating campaigns that promote travel packages, destinations, special offers, or seasonal deals (e.g., summer vacations, winter getaways).Developing targeted strategies for specific groups, such as adventure travelers, luxury travelers, or family vacations.Utilizing data on customer preferences (location, age, interests) to...
-
Cybersecurity Research Content Specialist
3 weeks ago
General Santos, Soccsksargen, Philippines Limelight Health Full timeOverviewThreat Intelligence Research Content Marketer (Principal Security Analyst)About SecurityScorecardSecurityScorecard is the global leader in cybersecurity ratings, with over 12 million companies continuously rated, operating in 64 countries. Founded in 2013 by security and risk experts Dr. Alex Yampolskiy and Sam Kassoumeh and funded by world-class...
-
General Santos, Philippines Buscojobs Full timeMedical Virtual Assistant - Arizona (Remote) Posted 8 days ago • Permanent • This is a remote position. Virtual Rockstar is hiring a reliable and detail-oriented Medical Virtual Assistant for a physical therapy practice in Arizona (MST). This fully remote, full-time, long-term role supports clinical and administrative operations to ensure smooth, timely,...
-
Business Funding Expert
1 week ago
General Santos, Philippines Orange Ashes VA Full timePosition Overview We’re seeking a Business Funding Expert to become an integral part of our funding operations. You’ll assist with client qualification, business structuring, funding applications, and post-funding support. Working closely with our team, you’ll help entrepreneurs gain access to capital while ensuring smooth communication and...
-
Quality Assurance Inspector
2 weeks ago
General Trias, Philippines San Miguel Corporation Full timeQualifications Graduate of 2-year course or College level Preferably with experience in raw materials and/or finished goods inspection in a manufacturing firm RESPONSIBILITIES Conducts sampling and evaluates raw materials, work in-process and finished goods according to the standard procedures and based on company's specifications Visually inspects...
-
Quality Assurance Inspector
2 weeks ago
General Trias, Philippines San Miguel Corp. Full timeSelect how often (in days) to receive an alert: Graduate of 2-year course or College level Preferably with experience in raw materials and/or finished goods inspection in a manufacturing firm RESPONSIBILITIES: Conducts sampling and evaluates raw materials, work in-process and finished goods according to the standard procedures and based on company's...
-
QA Specialist
2 weeks ago
General Trias, Philippines San Miguel Corporation Full timeOverview Select how often (in days) to receive an alert: Graduate of BS Food Technology, Chemistry, Bio-Chemistry, Biology or Microbiology or Chem. Engineering With our withoutprevious work experience Responsibilities Duties & Responsibilities Performs QA acceptance evaluation of RM, WIP and FG. Performs verification activities Warehouse Audits ...
-
QA Specialist
4 weeks ago
General Trias, Calabarzon, Philippines San Miguel Corporation Full timeOverviewSelect how often (in days) to receive an alert:Graduate of BS Food Technology, Chemistry, Bio-Chemistry, Biology or Microbiology or Chem. EngineeringWith our withoutprevious work experienceResponsibilitiesDuties & ResponsibilitiesPerforms QA acceptance evaluation of RM, WIP and FG. Performs verification activitiesWarehouse AuditsJob SegmentJob...
-
HR Talent Partner
18 hours ago
General Santos, Philippines ClearDesk Full time3 days ago Be among the first 25 applicants Direct message the job poster from ClearDesk At ClearDesk, you’ll enjoy the stability of long-term placement, the flexibility of remote work, and — for a limited time — a ₱20,000 sign-on bonus when you join our growing team of Recruiters. About the job Do you thrive in fast-paced recruiting environments...