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Medulla Recruitment Services
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Associate - (Prior Authorization or Eligibility Verification)

Associate - (Prior Authorization or Eligibility Verification)

Medulla Recruitment Services

2 - 7 years

1 - 5 Lacs

Hyderabad Mumbai (All Areas)

Posted:3 weeks ago| Platform:

Apply

Skills Required

RCM Authorization Eligibility Verification Revenue Cycle Management AR Calling US Healthcare

Work Mode

Work from Office

Job Type

Full Time

Job Description

Excellent Opportunity for Associate - (Prior Authorization or Eligibility Verification) with Leading

Please share your resume or call on 9226254897/ 8308816436/ 9356590554

Work Location: Mumbai / Hyderabad

Shift Time:

Benefits:

Incentives
Night shift allowance
Two-way cab facility

1) Role For Prior Authorization:

Obtains prior-authorizations and referrals from insurance companies prior to procedures or Surgeries utilizing online websites or via telephone.
Monitors and updates current Orders and Tasks to provide up-to-date and accurate information.
Provides insurance companies with clinical information necessary to secure prior-authorization or referral.
Good understanding of the medical terminology and progress notes.
Obtains and/or reviews patient insurance information and eligibility verification to obtain prior authorizations for injections, DME, Procedures, and surgeries.
Request retro-authorizations when needed.

2) Role for

Responsible for reaching out to the payor to check on the insurance eligibility and the

benefits of the patient.

Addressing the claims to insurance or Self Pay (Patient Attention) based on the

eligibility identified.

Responsible for achieving the defined TAT on deliverables with the agreed Quality

benchmark score.

Responsible for analyzing an account and taking the correct action.
Ensuring that every action to be taken should be resolution oriented whilst working

on the specific task/case assigned.

Task claims to appropriate teams where a specific department within clients

assistance is required to resolve them.

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