EV Callers

Should have a very strong verbal and written communication skill with the ability to speak confidently and interact with the insurance representatives on the phone calls with confidentiality and following the HIPAA compliance.

Ability to grasp all the information on the phone calls with attention to details and without missing out any information and document the same in tools like MS Word, Excel, PDF and any client applications and upload the same in shared drives.

Ability to read, understand and respond / reply to the emails & chats with a decent typing speed.

Should be able to escalate any complex situations to supervisors immediately for resolutions.

Should be able to understand the appropriateness of the information collected from the insurance representative and ability to check if the information given by the insurance representative is inadequate or unclear and recollect / recheck the information as per the requirements of the client / process.

Should have a clear understanding on basic Eligibility & Benefits terminologies like Co-ordination of Benefits, COBRA policies, ACA Policies, Exchange Policies, State restrictions, etc and various patient responsibilities like Co-insurance, Co-pay, Deductible, Out of Pocket responsibilities.

Should possess knowledge on various plan types like HMO PPO, POS, EPO, and other type plans set by insurance companies.

Should be able to navigate through the various EMRs, Insurance portals, IVR / AVR systems to collect the eligibility and benefits information and then perform outbound phone calls to the Benefits department of the insurance companies in the United States to get all required eligibility and benefits information.

Should be also able to make phone calls to the Authorization / Utilization Review Department and initiate and get Authorization approvals if required for a service, should be able to fax the records and make subsequent follow-ups if authorization requests are denied.

Ensuring accurate and timely completion of each Verification request within the given TATs and SLAs set by the organization & client.

Should be flexible to work on multiple clients / processes each day without any hesitations.

Should be flexible to work in any US time zones (Eastern / Mountain / Central / Pacific / Hawaii) on a rotational basis (predominantly a night shift job).