6 Preauthorization Jobs

As a Credentialing Specialist, you will play a crucial role in our healthcare operations team by managing end-to-end credentialing and re-credentialing processes. Your primary responsibility will be ensuring the efficiency of the revenue cycle by handling tasks such as maintaining accurate provider data, tracking expirables, and collaborating with billing teams. You will be responsible for interacting with insurance companies and regulatory bodies to follow up on application statuses and resolve any issues that may arise. Additionally, you will work closely with the RCM team to support eligibility, pre-authorization, and claim submission tasks. Your attention to detail and organizational skills will be essential in maintaining timely renewals and accurate credentialing status. To succeed in this role, you should have a minimum of 2 years of experience in provider credentialing and RCM processes. Familiarity with the U.S. healthcare system, medical billing cycles, and denial management is also required. Excellent communication skills, both verbal and written, are essential, along with the ability to multitask, prioritize, and manage time effectively. Proficiency in MS Office and credentialing software/tools is a must. This is a full-time position with night shift hours (06:30 PM - 03:30 AM) from Monday to Friday. The work location is in person. In addition to competitive compensation, benefits such as leave encashment, paid time off, and Provident Fund are also provided. If you are a highly organized and detail-oriented individual with a passion for healthcare operations, we would love to have you join our team as a Credentialing Specialist.,

Job Title : AR Caller & US Healthcare Medical Billing RCM Specialist Job Description : We are seeking a skilled AR Caller & US Healthcare Medical Billing RCM Specialist to manage and optimize revenue cycle processes for our healthcare clients. The ideal candidate will handle accounts receivables, follow up on denied or unpaid claims, and work directly with insurance companies to resolve outstanding issues. The role requires a deep understanding of medical billing, claims processing, and insurance follow-up within the US healthcare system. Key Responsibilities : Manage accounts receivable, including timely follow-up on unpaid claims Call insurance companies to resolve denied or delayed claims Investigate and address claim rejections or underpayments Review and submit appeals for denied claims Maintain accurate documentation and reporting on claim statuses Collaborate with billing teams to improve revenue cycle processes Stay updated on payer rules, regulations, and changes in billing practices Qualifications : 1+ years of experience in US healthcare billing and RCM processes Familiarity with EOBs, denials, and insurance payer policies Excellent communication and negotiation skills Proficiency in medical billing software and MS Office Hiring for freshers salary 10.7k to 17k ( Depends on last drawn salary) Location- Mumbai *FOR EXPERIENCE CANDIDATES IN MEDICAL BILLING (Voice Process)* Salary upto 50k open for right candidate/ decent hike on last drawn/ 25k joining bonus only Home Pickup and Home Drop facility provided. If travelling not taken then 4000 allowance provided. Us shift/ 5:30pm-2:30am Monday-Friday working / Saturday & Sunday Fixed Off. Location :- Navi Mumbai, Mumbai, Hyderbad, Banglore, Pune Extra Perks: - Incentives - up to 5500 Overtime - per hour 150rs & If working on Saturday - Double Salary Preferred : Certification in Medical Billing and Coding or equivalent Experience with Medicare/Medicaid billing Location: Pune / Navi Mumbai / Bangalore / Andheri / Ghansoli / Airoli /Hyderabad Job Type : Full-time Contact Details. SR.HR Shreya - 9136512502

SUMMARY OF RESPONSIBILITIES The position of Prior Authorization Specialist is responsible for processing prior authorization requests for Surgical procedures, prescriptions, Imaging, PT etc. Job description: (1) Processes prior authorization requests relating to procedures, radiology, Physical Therapy, prescriptions from pharmacists. This may include receiving a request form via fax or telephone; reviewing the patients chart to verify the Medical record, prescription, patient data, and the proper diagnoses; uploading patients office notes; requesting prior authorizations by speaking personally with the insurance company representatives by phone or via internet portals, receiving immediate authorization or requesting to be placed onto pending queue for a response within 24-72 hours; expediting urgent requests to generate a same day response; answering questions from insurance company representatives; monitoring incoming faxes for authorizations and adding the authorizations and confirmation numbers to the patients charts; and delivering the authorizations to the pharmacist, or otherwise notifying pharmacist of determination. (2) Processes prior authorization requests relating to procedures, imaging, physical therapy prescriptions from provider teams via EMR message in an efficient and timely manner. (3) Requests clarification regarding diagnosis codes and office notes from provider teams as needed via EMR message. (4) When necessary, monitors incoming fax messages and distributes them to appropriate personnel or chart in an efficient and timely manner. (5) Assistant with scanning, as well as duties of Prior Authorizations Specialist (Imaging), when necessary. (6) Performs other related duties as assigned. Prerequisites: Minimum 1 year of experience in Pre-Auth in Procedures (preferred), Peer to Peer Review, Auth related appeals/denials, well versed with EVBV (Eligibility Verification and Benefit Verification). Excellent oral and written communication skills Knowledge of current medical terminology to communicate with physician, staff, and patients High level of attention to detail Strong organization, filing, and time management skills Basic computer literacy and typing Patient focused Good communication skills with RCM knowledge Knowledge of third party payer regulations including Medicare, Medicaid, Veterans Affairs (VA) and commercial insurances. Ok with Night shift. Ok with Work from office - Location: Navi Mumbai

Hiring For Reputed BPO N KPO (Work from office) Excellent English Required Telephonic Interviews Voice/ Chat/Blended Process/Collections /Customer service Specialize in-Medical billing/Travel n Ticketing HSC/GRAD Fresher +6 months any bpo exp apply(on paper) 2 week offs,Transpot provided Salary 12K- 55 K + Inc Medical Billing :- upto 50k + Incentives +Travelling allowance SR.HR Shreya :- 9136512502 or mail CV on jobway.resume@gmail.com walk-In :- Jobway Recruitment ( Airoli W) , 1St Floor, Plot No H-132, Above Sai Optic, Opposite To Kotak Bank Atm, Near Bus Depo, Sector-3, Airoli , Navi Mumbai, Maharashtra 400708

* Good knowledge about TPA. * Must have handled Insurance Pre Authorise and final billing enhancement. * Preparing daily report. * Daily patient visit. * Willing to do COVID duty.Roles and Responsibilities Candidate Profile Any Graduate with 1 - 4 years of experience in Hospital insurance -Pleasant Personality with good communication skills. -Interested candidates please forward your resume to Whatsapp number 7299052617

Job Title : AR Caller & US Healthcare Medical Billing RCM Specialist Job Description : We are seeking a skilled AR Caller & US Healthcare Medical Billing RCM Specialist to manage and optimize revenue cycle processes for our healthcare clients. The ideal candidate will handle accounts receivables, follow up on denied or unpaid claims, and work directly with insurance companies to resolve outstanding issues. The role requires a deep understanding of medical billing, claims processing, and insurance follow-up within the US healthcare system. Key Responsibilities : Manage accounts receivable, including timely follow-up on unpaid claims Call insurance companies to resolve denied or delayed claims Investigate and address claim rejections or underpayments Review and submit appeals for denied claims Maintain accurate documentation and reporting on claim statuses Collaborate with billing teams to improve revenue cycle processes Stay updated on payer rules, regulations, and changes in billing practices Qualifications : 1+ years of experience in US healthcare billing and RCM processes Familiarity with EOBs, denials, and insurance payer policies Excellent communication and negotiation skills Proficiency in medical billing software and MS Office Hiring for freshers salary 10.7k to 25k ( Depends on last drawn salary) Location- Mumbai *FOR EXPERIENCE CANDIDATES IN MEDICAL BILLING (Voice Process)* Salary upto 50k open for right candidate/ decent hike on last drawn/ Home Pickup and Home Drop facility provided. If travelling not taken then 4000 allowance provided. Us shift/ 5:30pm-2:30am Monday-Friday working / Saturday & Sunday Fixed Off. Location :- Navi Mumbai, Mumbai, Hyderbad, Banglore, Pune, Andheri, Turbhe Extra Perks: - Incentives - up to 5500 Overtime - per hour 150rs & If working on Saturday - Double Salary Preferred : Certification in Medical Billing and Coding or equivalent Experience with Medicare/Medicaid billing Location: Pune / Navi Mumbai / Bangalore / Andheri / Ghansoli / Airoli /Hyderabad Job Type : Full-time Contact Details. SR.HR Shreya - 9136512502