Prior Authorization Specialist

• Voice Process
• NP: Immediate joiners 30days 
• Mode of Interview : Virtual
• 2 Rounds of Interview 

^{Relocation candidates are accepted Virtual Interview can be done}

Role: Prior Authorization Specialist

Job Summary:

We are seeking experienced and detail-oriented Prior Authorization Specialists with a strong understanding of medical terminology and healthcare insurance processes. The ideal candidate will be responsible for obtaining prior authorizations and referrals from insurance companies, verifying patient insurance eligibility, and coordinating with payers to ensure timely approvals for procedures, surgeries, injections, and DME services.

Key Responsibilities:

 Obtain prior authorizations and referrals from insurance companies through payer portals and telephonic communication.

 Verify patient insurance coverage, benefits, and eligibility requirements.

 Review and process authorization requests for procedures, surgeries, injections, and Durable Medical Equipment (DME).

 Provide insurance companies with the necessary clinical documentation to secure approvals.

 Track, monitor, and update authorization statuses, orders, and tasks in the system.

 Follow up with insurance providers on pending authorization requests.

 Maintain accurate records and ensure compliance with payer guidelines and organizational standards.

 Collaborate with physicians, clinical staff, and insurance representatives to resolve authorization-related issues.

 Ensure timely completion of authorization requests to avoid delays in patient care.

Required Skills & Qualifications:

 Minimum 1.6+ years of experience in Prior Authorization / Pre- Authorization.

 Strong knowledge of medical terminology and healthcare insurance processes.

 Experience working with insurance portals and payer guidelines.

 Excellent communication and follow-up skills.

 Strong attention to detail and documentation accuracy.

 Ability to work in a fast-paced healthcare environment.

 Familiarity with EMR/EHR systems is preferred.

Preferred Candidate Profile:

 Experience handling authorizations for surgeries, procedures, injections, and DME.

 Good analytical and problem-solving skills.

 Should be a Graduate.

 Ability to manage multiple tasks with minimal supervision.

Benefits:

✅ Night Shift Allowance: ₹100 per working day

✅ Fixed Week Offs: Saturday & Sunday

✅ Two-Way Cab Facility (Within 25 KM Radius)

✅ Self-Transportation Allowance up to ₹3,500 per month

✅ Excellent Career Growth Opportunities