Healthcare Account Representative

About the role

Edge is building a bridge between top global talent and the US healthcare and insurance industry, with people at the center of its mission to create a borderless network of exceptional talent.

As a healthcare account representative for US-based healthcare providers, you will act as a liaison between patients, healthcare providers, and insurance companies. The role requires navigating insurance portals and electronic health records while helping patients receive timely access to care.

Responsibilities

• Check patient eligibility and verify benefits before scheduled appointments.
• Interpret insurance policies, including PPO, HMO, and Medicare/Medicaid guidelines.
• Determine and document patient financial responsibilities, including deductibles, copays, and coinsurance.
• Prepare and submit prior authorization requests through web portals, fax, or phone.
• Review clinical documentation to ensure medical necessity criteria are met before submission.
• Track pending authorizations, manage appeals for denied claims, and expedite urgent requests.
• Handle inbound and outbound calls to schedule, reschedule, and remind patients about wellness visits and routine checks.

Requirements

• At least 1 year of direct experience in the US healthcare industry, including scheduling, eligibility, or prior authorizations.
• Meticulous and tech-savvy, with the ability to navigate complex insurance portals and electronic health records.

How to apply

Apply directly on CazVid.

Datos clave

• Requires at least 1 year of direct experience in the US healthcare industry.
• Responsibilities include eligibility checks, benefits verification, prior authorizations, and patient scheduling.
• Apply directly on CazVid.

Salario estimado

Salario estimado para servicio al cliente en Costa Rica: CRC 480 - 380.000 al mes, según 5 ofertas con salario publicado en CazVid. Es una estimación, no el salario ofrecido.