Hiring - Prior Authorization Caller (US Healthcare) | Oncospark

Oncospark

1 - 4 years

3 - 5 Lacs

chennai

Posted:2 days ago| Platform:

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Skills Required

authorization eligibility verification insurance verification us healthcare

Work Mode

Work from Office

Job Type

Full Time

Job Description

Roles & Responsibilities :

Review patient demographics, insurance details, and clinical information in the system prior to initiating authorization.

Verify insurance eligibility and benefits through payer portals or telephonic verification.
Identify coverage limitations, copays, deductibles, and referral requirements.
Confirm if prior authorization is required based on CPT/HCPCS codes and payer policy.

Contact insurance carriers via phone, fax, or payer portals (e.g., Availity, NaviNet, Epic, UnitedHealthcare portal, etc.) to initiate authorization requests.
Submit required clinical documentation, physician orders, and medical records to obtain timely approval.
Ensure accurate entry of authorization numbers, start/end dates, and validity period in the EMR or billing system.
Track turnaround times (TAT) to ensure services are not delayed due to pending authorizations.

Required Skillset :

In-depth knowledge of
US healthcare insurance
, payer requirements, and RCM workflow.
Understanding of
CPT, ICD-10, and HCPCS codes
related to medical procedures.
Strong communication and analytical skills for interacting with insurance representatives and clinical teams.
Proficiency in using
payer portals
(Availity, NaviNet, UHC Link, Aetna, Anthem, etc.) and EMR systems (Epic, eClinicalWorks, Cerner).
High attention to detail and ability to handle high-volume work with accuracy.

Please share your updated resume to hr@oncospark.com. Contact - Sangeeth : 7824834817.

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