Prior Authorisation Specialist – US Healthcare

Job Title: Prior Authorisation Specialist – US Healthcare

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🔹 Job Overview

Prior Authorisation Specialist

The role involves obtaining insurance authorisation for medical procedures, coordinating with insurance payers, and ensuring complete and accurate documentation in EMR systems.

🔹 Key Responsibilities

• Perform

  prior authorisation

  for procedures, tests, and medications.
• Contact

  insurance payers

  via portal or phone to verify eligibility and requirements.
• Document all communication and outcomes accurately in EMR systems.
• Submit clinical documents, CMNs, and medical justification required by payers.
• Coordinate with providers, facilities, and ordering physicians as needed.
• Ensure compliance with HIPAA and organisational confidentiality protocols.
• Meet productivity and accuracy targets within deadlines.

🔹 Required Skills & Experience

• 6 months+ experience in

  Prior Authorisation / Insurance Verification / DME / Medical Scribing / US Calling

  (RCM domain preferred)

Strong understanding of:

• Prior authorisation workflow
• Eligibility & benefits verification
• ICD/CPT codes (preferred)
• Strong verbal and written communication skills.
• Ability to multitask and work effectively in a fast-paced environment.

🔹 Education

• Graduate in any stream
• Medical / life science background preferred (not mandatory)

💡 What We Offer

• Competitive salary + performance-based incentives
• Growth opportunities within the U.S. Healthcare domain
• Supportive team culture and training opportunities

📩 Interested? Apply Now!

Send your resume to:

90567-10352 (WhatsApp / Call)

or comment / DM directly on LinkedIn.