Medical Insurance Verification Agent - U.S. Healthcare | EST Hrs (Remote)
RemoteSouth Africa
Job Summary
Verify patient insurance eligibility and benefits using U.S. insurance portals, accurately capturing and documenting coverage information while managing 10–15 Verification of Benefits (VOB) requests daily. Retrieve medical records, prepare utilization review packets, and submit authorization requests via email, fax, or telephone to insurance providers. Follow up on pending requests, monitor expiry dates, and proactively obtain extensions to ensure timely approvals. Maintain precise records of all authorization outcomes and communicate coverage discrepancies to relevant parties. Requires a fixed fibre internet connection with power backup and experience with U.S. healthcare systems.
Required Qualifications
- Previous experience within U.S. healthcare or U.S. medical insurance
- Excellent English communication skills — strong conversational fluency, comprehension and professional written communication
- Previous experience with insurance verification, eligibility, benefits, authorizations or pre-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, substance use treatment, ABA or another U.S. healthcare environment
- Familiarity with U.S. commercial insurance and/or managed care
- A dedicated, fixed FIBRE internet connection with a minimum speed of 25 Mbps upload and 25 Mbps download
- A reliable backup power solution that can support your equipment for the duration of your scheduled working hours during power outages (UPS, inverter, solar, etc.)
- Required to work on all South African public holidays
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