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. Apply tot his job Apply To this Job