Eligibility & Verification- Senior Executive

About Job Role:

● Review and verify client information to determine eligibility for specific benefits or programs. ● Communicate with clients or relevant parties to gather necessary information. ● Verify and analyse insurance coverage details, including co-pays, deductibles, and coverage limits. ● Determine the extent of benefits available to clients based on their eligibility status. ● Maintain accurate and up-to-date records of client information, eligibility status, and benefit details. ● Document verification processes and outcomes for future reference. ● Communicate eligibility and benefit information to clients, colleagues, or relevant stakeholders. ● Provide clear explanations of benefits, coverage details, and any necessary actions required. ● Address and resolve any discrepancies or issues related to eligibility or benefits. ● Collaborate with other departments or teams to ensure accurate information flow. ● Stay informed about relevant laws, regulations, and industry standards related to eligibility and benefits. ● Ensure compliance with all applicable guidelines and policies. ● Provide excellent customer service by responding to inquiries, addressing concerns, and assisting clients in understanding their benefits.

● Any graduate or equivalent; additional education or certifications in healthcare administration or related fields may be preferred. ● Previous experience in eligibility verification, benefit analysis, or a similar role. ● Knowledge of insurance policies, financial assistance programs, or relevant benefits. ● Strong attention to detail and accuracy. ● Excellent communication and interpersonal skills.