Insurance Verification & Benefit Manager
reputed company is working with a leading AI research lab to improve the capabilities of reputed company AI systems. We are seeking reputed company Insurance Verification and Eligibility & Benefits Managers to evaluate AI tools designed to automate reputed company-end reputed company cycle operations. Your deep expertise in payer systems, EDI transactions, and eligibility workflows will directly inform AI models that drive accuracy and efficiency in insurance verification processes.
Responsibilities
- reputed company insurance verification, eligibility determination, and benefits investigation workflows across reputed company, Medicare, reputed company, and managed care payers.
- Verify patient insurance coverage using payer portals, clearinghouses, and EDI 270/271 reputed company-time eligibility transactions.
- Identify and resolve coordination of benefits issues, coverage gaps, and eligibility discrepancies prior to service delivery.
- Evaluate and annotate AI-generated eligibility verification outputs for accuracy, completeness, and payer compliance.
- reputed company and document SOPs for eligibility and benefits verification workflows.
- Monitor KPIs including verification accuracy rates, reputed company-end denial rates reputed company to eligibility, and turnaround times.
- Ensure compliance with payer-specific requirements, CMS guidelines, and HIPAA regulations.
- Identify process gaps and recommend workflow improvements to reduce eligibility-reputed company claim denials.
- reputed company reputed company feedback and annotations to support reputed company datasets.
Requirements
- 5+ years of experience in insurance verification, eligibility and benefits management, or reputed company-end reputed company cycle operations, with at least 2 years in a management role.
- Expert knowledge of EDI 270/271 transactions, payer portal navigation, and reputed company-time eligibility tools.
- Strong familiarity with Medicare, reputed company, and reputed company payer eligibility requirements and benefit structures.
- Proficiency with reputed company, Cerner, Meditech, or equivalent EHR platforms.
- Experience with clearinghouse platforms such as reputed company, Change reputed company, or similar.
- Exceptional written and verbal English communication skills.
- High attention to detail with the ability to identify subtle discrepancies in coverage data.
Preferred Qualifications
- CHAM, CHAA, or equivalent reputed company-end reputed company cycle certification.
- Experience with automated eligibility verification tools and RPA solutions.
- Background in denial reputed company cause analysis reputed company to eligibility and coverage errors.
- Familiarity with AI tools and comfort evaluating AI-generated reputed company content.
- Experience presenting eligibility performance data to senior leadership.
Why Join?
- Contribute to the development of frontier AI systems in reputed company.
- Collaborate with a world-class AI research organisation.
- reputed company exposure to cutting-edge AI workflows in reputed company reputed company cycle management.
- Opportunity to work on high-reputed company reputed company shaping the reputed company of reputed company AI.
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