Prior Authorization Specialist

Overview

We are looking for skilled Prior Authorization Specialists with a comprehensive understanding of medical terminology and healthcare insurance protocols. The role involves securing prior approvals and referrals from insurance providers, verifying patient insurance eligibility, and coordinating with payers to guarantee timely authorization for medical procedures, surgeries, injections, and Durable Medical Equipment (DME) services.

Key Responsibilities

• Obtain prior authorizations and referrals from various insurance companies.
• Verify patient insurance coverage and eligibility details.
• Work in coordination with payers to ensure approval for surgeries, procedures, injections, and DME services within stipulated timelines.
• Maintain accurate documentation related to authorizations.

Requirements

• Minimum of 1.6 years up to 4 years of experience in Prior Authorization or Pre-Authorization roles.
• Strong grasp of medical terminology and healthcare insurance systems.
• Proficient in using insurance portals and adhering to payer regulations.
• Effective communication and follow-up capabilities.
• Excellent attention to detail and precision in documentation.
• Ability to perform effectively in a dynamic healthcare setting.
• Familiarity with EMR or EHR systems is advantageous.
• Experience managing authorizations specifically for surgeries, injections, procedures, and DME products.
• Good analytical thinking and problem-solving skills.
• Graduation degree required.
• Capability to handle multiple responsibilities independently with minimal supervision.

Compensation & Benefits

• Salary range between 300,000 and 500,000 INR annually.
• Night shift allowance of 100 INR per working day.
• Fixed weekly off days on Saturday and Sunday.
• Two-way cab service provided within a 25 km radius.
• Self-transportation allowance up to 3,500 INR per month.
• Opportunities for career development and growth within the organization.