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Medical EV & Authorization Executive

Medical EV & Authorization Executive

Technocruitx

1 - 3 years

1 - 4 Lacs

Ahmedabad

Posted:1 day ago| Platform:

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Skills Required

Medical EV Prior Authorization

Work Mode

Work from Office

Job Type

Full Time

Job Description

Job Title:

Job Summary:

Medical EV & Authorization Executive

Key Responsibilities:

Eligibility Verification (EV):

Verify patients' insurance coverage via online portals or by contacting payers.
Confirm plan details including active status, co-pay, deductible, co-insurance, and coverage limits.
Document all eligibility verification findings accurately in the internal system.

Prior Authorization:

Obtain prior authorizations for medical procedures, tests, or medications by coordinating with insurance companies.
Submit required documents in a timely manner for approval.
Follow up regularly with payers to ensure authorizations are received without delay.

Coordination and Communication:

Collaborate with healthcare providers and clients to gather any missing information.
Maintain clear and timely communication with team members.
Escalate issues promptly to ensure workflow efficiency.

Compliance and Documentation:

Ensure compliance with HIPAA regulations and company policies.
Maintain accurate records of all interactions and communications with insurance payers.

Required Skills & Qualifications:

6 months to 3 years of experience in Medical Eligibility Verification and Prior Authorization (US healthcare process).
Strong verbal and written communication skills in English.
Proficiency in navigating insurance portals and healthcare software systems.
Basic knowledge of medical terminology and US insurance plans (PPO, HMO, Medicaid, Medicare, etc.).
Ability to multitask, stay organized, and meet deadlines.

Benefits:

5-day working week
Free meal facility
Supportive and collaborative work culture
Career growth opportunities

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