About Us At NextDimension AI, our mission is to simplify healthcare. We are a technology company building the next generation of AI-powered systems to automate complex workflows and create a more responsive, patient-centric experience. We have bold ambitions to reimagine healthcare, setting a new standard for how care is delivered and experienced across the industry. Our growing suite of AI solutions spans the Front Office, Clinical Operations, and Revenue Cycle Management. Website: nextdim.io Healthcare's moment for AI-powered transformation is here, and we're building the technology to power it. Come join us in shaping the future of healthcare. Role Description As a Prior Authorization Specialist for Procedures, you will be a crucial link between our patients, our clinical team, and insurance carriers. Your primary responsibility will be to secure financial clearance for all office-based and hospital-based gastroenterology procedures, such as endoscopies, colonoscopies, and capsule endoscopies. You will manage a high volume of authorization requests, meticulously track their status, and ensure all necessary approvals are in place before the patient's scheduled service. Key Responsibilities: Verify patient insurance eligibility and benefits for all scheduled GI procedures. Initiate, submit, and diligently follow up on prior authorization requests through insurance portals, phone, and fax. Gather and attach required clinical documentation (physician notes, lab results, imaging reports) to justify medical necessity. Communicate effectively with physicians, nurses, and scheduling staff regarding the status of authorizations. Document all activities and outcomes accurately in the patient's electronic health record (EHR). Address and resolve initial authorization rejections or requests for additional information. Qualifications: Minimum of 2 years of experience in medical prior authorizations, specifically for surgical or medical procedures. Strong understanding of CPT (procedural) and ICD-10 (diagnostic) codes is required. Demonstrated experience navigating the portals of major medical insurance carriers (e.g., UnitedHealthcare, Aetna, Cigna, BCBS). Ability to read and interpret clinical documentation to extract information supporting medical necessity. Excellent organizational skills and the ability to manage a large caseload with competing deadlines. Experience in gastroenterology or surgical practice is highly preferred. Compensation: Base Salary: INR 5-8 LPA Bonus: Upto 10% based on performance. Job Type: Full-time Pay: ₹40,000.00 - ₹60,000.00 per month Benefits: Paid time off Application Question(s): Do you have experience with CPT (procedural) and ICD-10 (diagnostic) codes ? Experience: Medical Prior Authorization: 2 years (Required) Location: Gurgaon, Haryana (Required) Shift availability: Night Shift (Required) Work Location: In person
Job Summary: The Service Center Representative is a crucial role responsible for managing all inbound patient communications with professionalism and compassion. You will handle a high volume of calls related to scheduling appointments, managing prescription refills, answering inquiries, and directing calls to the appropriate clinical staff. The ideal candidate is an outstanding communicator with a passion for helping others and experience in a fast-paced healthcare environment. Key Responsibilities: Answer incoming calls in a timely and professional manner, providing a high level of customer service. Schedule, reschedule, and cancel patient appointments accurately in our EMR (Electronic Medical Record) system. Process prescription refill requests and coordinate with pharmacies and clinical staff. Provide patients with information regarding their appointments, preparations for procedures, and general practice policies. Address and resolve patient questions and concerns, or escalate issues to the appropriate manager or clinical personnel when necessary. Verify patient demographic and insurance information, ensuring our records are accurate and up-to-date. Maintain patient confidentiality and adhere to all HIPAA regulations. Perform other administrative duties as assigned to support the call center operations. Qualifications: High school diploma or equivalent required; Associate's or Bachelor's degree preferred. Minimum of 2 years of experience in a customer service or call center role. Previous experience in a healthcare setting (e.g., hospital, medical practice, clinic) is strongly preferred. Prior experience serving US-based clients/patients is highly desirable. Familiarity with medical terminology and EMR systems (e.g., Epic, eClinicalWorks) is a significant plus. Exceptional verbal and written communication skills. Strong interpersonal skills with the ability to show empathy and patience. Excellent problem-solving skills and the ability to work effectively under pressure. Proficient in Microsoft Office Suite and comfortable learning new software systems. Must be reliable, punctual, and have a strong work ethic. Job Type: Full-time Pay: ₹40,000.00 - ₹65,000.00 per month Benefits: Paid time off Provident Fund Ability to commute/relocate: Gurugram, Haryana: Reliably commute or planning to relocate before starting work (Required) Experience: Customer service: 2 years (Required) Healthcare: 2 years (Preferred) Language: English (Required) Shift availability: Night Shift (Required) Expected Start Date: 03/11/2025