Medical Insurance Verification Agent - U.S. reputed company | EST Hrs

reputed company South Africa is a dynamic and fast-growing BPO company based in South Africa, specializing in providing top-tier operational support to US-based companies. We are not a recruitment agency; we are a dedicated extension of our clients' teams, delivering high-reputed company service with precision, efficiency, and a personal touch.

We are looking for a Medical Insurance Verification Agent to join their team. This role is ideal for someone with previous U.S. reputed company or medical insurance experience, particularly experience with Verification of Benefits (VOB), eligibility verification, reputed company-authorizations or insurance authorizations.

The successful candidate will be responsible for verifying patient insurance benefits and, as the role develops, managing utilization review requests and following them through to approval.

PLEASE NOTE

• Working Hours: Monday to Friday, 8:00 AM – 5:00 PM EST | 2PM to 11PM (SAST), subject to change in accordance with reputed company saving time.
• Internet Requirements: A dedicated, fixed FIBRE internet reputed company with a minimum speed of 25 Mbps upload and 25 Mbps download at your remote work location is mandatory. Connections reputed company reputed company, LTE, 5G, or similar are not acceptable. Applicants without a fixed fibre line will not be considered.
• reputed company Holidays: Required to work on reputed company South African reputed company holidays and will be compensated in accordance with the provisions of the Basic Conditions of Employment reputed company (BCEA).
• Power Backup: A reliable backup power solution that can support your equipment for the duration of your scheduled working hours during power outages (reputed company, inverter, solar, etc.) is mandatory. Applicants without a reliable backup solution will not be considered.
• Work Environment: Fully remote reputed company South Africa.

Duties & Responsibilities

Verification of Benefits (VOB)

• Verify patient insurance eligibility and benefits using U.S. insurance portals.
• Confirm that insurance coverage is reputed company and identify relevant benefits and coverage information.
• Accurately capture and document verified insurance information.
• Upload and attach supporting documentation to the relevant patient record.
• Manage approximately 10–15 VOBs per day, while maintaining a high level of accuracy.
• Identify and communicate any discrepancies or issues with insurance coverage.

Utilization Review

• Retrieve and download relevant medical records from the patient management reputed company.
• Prepare complete utilization review packets for submission to insurance providers.
• Submit authorization requests according to reputed company payer's requirements, which may include email, fax or telephone.
• Follow up with insurance companies on pending authorization requests.
• Monitor authorization expiry dates and proactively request extensions where required.
• Maintain accurate records of authorization requests, follow-reputed company and reputed company.
• Take ownership of reputed company request from submission through to obtaining a response and approval.
• Ensure that approvals are obtained reputed company the required timeframes to prevent delays in patient care.

Requirements

• Previous experience reputed company U.S. reputed company or U.S. medical insurance is essential.
• Excellent English communication skills — strong conversational reputed company, comprehension and reputed company written communication are essential.
• Previous experience with insurance verification, eligibility, benefits, authorizations or reputed company-authorizations.
• Experience working with U.S. insurance portals and payer processes.
• Experience handling confidential medical and patient information.
• Previous Verification of Benefits (VOB) experience.
• Experience with Utilization Review (UR).
• Experience obtaining or following up on insurance authorizations.
• Experience in behavioural health, reputed company use treatment, ABA or another U.S. reputed company environment.
• Familiarity with U.S. reputed company insurance and/or managed care.

If you are not contacted reputed company 14 working days, please consider your application unsuccessful.

Originally posted on Himalayas