Client Partner Prior Authorization

Role Overview: You will be responsible for initiating and following up on prior authorization requests with insurance companies for various healthcare services. You will coordinate with providers and clinical staff to gather necessary clinical documentation for authorization requests. It will be your duty to track the status of pending authorizations, ensure timely follow-up, and document all activities accurately in the client's system. Key Responsibilities: - Initiate and follow up on prior authorization requests with insurance companies. - Coordinate with providers and clinical staff to obtain necessary clinical documentation. - Track the status of pending authorizations and ensure timely follow-up. - Document all activities and communication in the client's system. - Verify and update patient demographics, insurance information, and authorization details. - Escalate complex cases or delays in approvals to the team lead or client contact. - Support denial prevention by ensuring accurate and complete submissions of authorization requests. Qualifications Required: - Any degree/diploma with 1 year of experience in prior authorization or insurance verification in US healthcare RCM. - Familiarity with major US insurance carriers like Medicare, Medicaid, and Commercial plans. - Understanding of clinical terminologies, CPT, ICD-10, and HCPCS codes. - Experience with EMR/RCM systems such as EPIC, Cerner, Athenahealth, etc. - Excellent verbal and written communication skills. - Ability to work effectively in a high-volume, deadline-driven environment.,