Insurance and Eligibility Specialist

About Contour

Contour Software has grown from a dozen people to over 2,000 staff across 3 cities, in less than 14 years.

As a subsidiary of Constellation Software Inc., we are proud to be part of a global enterprise software conglomerate that has grown to become one of the top 10 software companies in the world, with employees and customers in 100+ countries. With a broad-based and ever-growing portfolio of market-leading, vertical-market enterprise solutions covering more than 100 industry domains in predominantly mature markets, CSI's recipe creates the perfect environment for professionals to build fulfilling, long-term careers.

What started as an R&D & Accounting back-office, has progressed into a full-service Global Centre serving all functions and departments, at the divisional as well as operating group/corporate level. Today Contour employees, located in Karachi, Lahore & Islamabad, are serving CSI divisions located in time zones spanning the globe, from Sydney to Vancouver. With the global growth of Constellation as the wind in our sails, we are only just getting started!

The Division

Constellation Kidney Group is a healthcare software company focused exclusively on kidney care and dialysis providers. It operates as part of Miram Solutions, which itself is a portfolio within the Perseus Operating Group of Constellation Software.

Role Overview

A Revenue Cycle Management Insurance and Eligibility Specialist involves several critical tasks that help ensure that healthcare providers are reimbursed for their services while also providing a positive experience for patients.

Purpose: To verify patient insurance coverage, assess eligibility for benefits, and ensure accurate information is processed for billing and claims submission.

Responsibilities

• Insurance Verification: Verify patient insurance information before appointments or procedures. Contact insurance companies to confirm coverage details and eligibility.
• Eligibility Assessment: Determine patient eligibility for services based on their insurance plans. Ensure pre-authorizations are obtained for specific treatments or procedures.
• Data Management: Accurately input and update patient insurance information in the electronic health record (EHR) and billing systems. Maintain detailed records of verification processes and outcomes.
• Patient Communication: Inform providers about patient insurance benefits, potential out-of-pocket costs, and any necessary documentation they need to provide. Address any questions or concerns related to insurance status.
• Claims Support: Collaborate with the billing department to ensure accurate claims submission based on verified eligibility. Assist in resolving any issues related to denied claims due to eligibility problems.
• Compliance: Ensure all processes comply with healthcare regulations and organizational policies. Stay updated on changes in insurance policies and procedures including HIPAA and fair debt collection practices.
  
  

Skills

• Attention to Detail: Accuracy in verifying and entering data is crucial to avoid billing errors.
• Strong Communication: Ability to explain insurance details clearly to patients and collaborate effectively with insurance companies.
• Analytical Thinking: Problem-solving skills to navigate complex insurance scenarios and resolve discrepancies.
• Familiarity with Healthcare Regulations: Understanding of HIPAA and other compliance standards related to patient information.
• Technical Skills: Proficiency in using EHR and billing software. Skilled in use of PC computer, skilled in use of Microsoft Office Suite, skilled in use of internet.
  
  

Experience And Education

• Minimum Education: High school diploma or equivalent is required.
• Certifications: Relevant certifications, such as Certified Revenue Cycle Specialist (CRCS) or Certified Medical Coder (CPC), can enhance job prospects and demonstrate expertise.
• Minimum experience: 2 years – 3 years of billing and collections management experience. Previous experience in customer service or healthcare billing can be advantageous but is not required.
  
  

Exciting Benefits We Offer

• Market-leading Salary
• Medical Coverage – Self & Dependents
• Parents Medical Coverage
• Provident Fund
• Employee Performance-based bonuses
• Home Internet Subsidy
• Conveyance Allowance
• Profit Sharing Plan [Tenured Employees Only]
• Life Benefit
• Child Care Facility
• Company Provided Lunch/Dinner
• Professional Development Budget
• Recreational area for in-house games
• Sporadic On-shore training opportunities
• Friendly work environment
• Leave Encashment
  
  

Disclaimer: At Contour, we attribute our success to the unique contributions of our diverse staff. We’re committed to fostering a culture of respect that thrives on the varied perspectives and experiences of all individuals we recruit, employ, promote, and compensate. Since day one, we’ve adhered to a policy that champions a work environment honoring the worth and dignity of each person while being free from all forms of employment discrimination.

In our continuous effort to promote inclusivity, we extend our commitment to individuals with special needs by providing reasonable accommodations. We actively encourage qualified individuals with special needs to apply for the various openings within our company. Should you require assistance in completing the application process or have any inquiries regarding special facilities, please do not hesitate to contact our HR team. Your unique talents and abilities are welcomed and valued here.