Aait Health Rcm

Job description: Good communication skills with RCM knowledge Knowledge of Insurance AR follow up, Denial management, Appeal creation. Minimum 1 year of experience in AR follow up & denials is a must Ok with Night shift Ok with Work from office - Location: Navi Mumbai

SUMMARY OF RESPONSIBILITIES The position of Prior Authorization Specialist is responsible for processing prior authorization requests for Surgical procedures, prescriptions, Imaging, PT etc. Job description: (1) Processes prior authorization requests relating to procedures, radiology, Physical Therapy, prescriptions from pharmacists. This may include receiving a request form via fax or telephone; reviewing the patients chart to verify the Medical record, prescription, patient data, and the proper diagnoses; uploading patients office notes; requesting prior authorizations by speaking personally with the insurance company representatives by phone or via internet portals, receiving immediate authorization or requesting to be placed onto pending queue for a response within 24-72 hours; expediting urgent requests to generate a same day response; answering questions from insurance company representatives; monitoring incoming faxes for authorizations and adding the authorizations and confirmation numbers to the patients charts; and delivering the authorizations to the pharmacist, or otherwise notifying pharmacist of determination. (2) Processes prior authorization requests relating to procedures, imaging, physical therapy prescriptions from provider teams via EMR message in an efficient and timely manner. (3) Requests clarification regarding diagnosis codes and office notes from provider teams as needed via EMR message. (4) When necessary, monitors incoming fax messages and distributes them to appropriate personnel or chart in an efficient and timely manner. (5) Assistant with scanning, as well as duties of Prior Authorizations Specialist (Imaging), when necessary. (6) Performs other related duties as assigned. Prerequisites: Minimum 1 year of experience in Pre-Auth in Procedures (preferred), Peer to Peer Review, Auth related appeals/denials, well versed with EVBV (Eligibility Verification and Benefit Verification). Excellent oral and written communication skills Knowledge of current medical terminology to communicate with physician, staff, and patients High level of attention to detail Strong organization, filing, and time management skills Basic computer literacy and typing Patient focused Good communication skills with RCM knowledge Knowledge of third party payer regulations including Medicare, Medicaid, Veterans Affairs (VA) and commercial insurances. Ok with Night shift. Ok with Work from office - Location: Navi Mumbai

Position Summary: We are seeking a skilled and detail-oriented Software Developer to design, develop, and implement Robotic Process Automation (RPA) solutions using Microsoft Power Automate. The ideal candidate will collaborate with cross-functional teams to analyze business processes, identify automation opportunities, and create efficient workflows that enhance productivity and reduce manual effort. Key Responsibilities: 1. Design and Development: a. Develop RPA solutions using Microsoft Power Automate and integrate with other Microsoft tools (e.g., Power Apps, SharePoint, Teams, Dataverse). b. Create and maintain reusable workflows, connectors, and templates for scalable automation. c. Implement process monitoring, exception handling, and error management within automation workflows. 2. Process Analysis: a. Work with stakeholders to analyze and document current manual processes. b. Identify opportunities for process improvement and automation. c. Create process flow diagrams and technical documentation. 3. Integration and Deployment: a. Integrate Power Automate solutions with other enterprise systems (e.g., CRM, ERP, or third-party APIs). b. Test, debug, and deploy RPA solutions in production environments. 4. Maintenance and Optimization: a. Monitor and maintain deployed automations to ensure high performance and reliability. b. Optimize existing workflows to improve speed and reduce errors. 5. Collaboration and Training: a. Collaborate with business units, developers, and other stakeholders to ensure alignment with organizational goals. b. Provide training and support to end-users and team members on Power Automate solutions. 6. Security and Compliance: a. Ensure all automation solutions comply with organizational security policies and data protection regulations. b. Implement access controls and audit mechanisms within workflows. Qualifications: Education: Bachelors degree in Computer Science, Information Technology, or related field (or equivalent experience). Technical Skills: Proficiency in Microsoft Power Automate Desktop, Power Apps, and the Power Platform ecosystem. Knowledge of RPA tools and principles. Experience with scripting languages (e.g., JavaScript, Python, or PowerShell). Familiarity with APIs, webhooks, and REST/SOAP integrations. Understanding of databases and query languages (e.g., SQL). Soft Skills: Strong problem-solving and analytical skills. Excellent communication and teamwork abilities. Attention to detail and ability to manage multiple projects. Experience: 2+ years of experience in RPA development, with a focus on Microsoft Power Automate. Experience with Microsoft Office 365 ecosystem, including SharePoint and Teams. Previous experience in workflow automation and process improvement. Flexible with the shift timings including CST shift Initially will be hired as contract employee and based on 6 months of performance, permanent position will be offered Work from office only Preferred Qualifications: Certification: Power Automate RPA Developer Associate Experience with AI Builder and other advanced features of Power Automate. Knowledge of agile project management methodologies.