Eligibility, Benefits Verification & Authorization Executive

Job Summary

Support insurance eligibility, benefits verification and prior authorization work for U.S. healthcare revenue-cycle operations.

Responsibilities

• Verify patient insurance eligibility and benefits through payer calls.
• Complete prior authorizations according to payer requirements.
• Review and interpret insurance responses to confirm coverage accuracy.
• Document detailed verification notes for each patient.
• Maintain turnaround-time and accuracy benchmarks.
• Collaborate with billing and coding teams for claims processing.
• Create documentation for the eligibility and benefits verification calling process.

Requirements & Qualifications

• Minimum two years of eligibility and benefits verification experience in an RCM environment.
• Strong written and verbal communication skills.
• Experience with insurance portals such as Availity or NaviNet and with EMR/EHR systems.
• Familiarity with commercial and federal insurance policies.
• Ability to work independently and during night-shift hours.