Prior Authorisation Specialist – US Healthcare

Job Title: Prior Authorisation Specialist – US Healthcare

Location: Mohali (Onsite)

Shift: Night Shift (US Hours)

Experience: 1 year – 3 years (Prior Authorisation / Insurance Verification / RCM) Employment Type: Full-time

Job Overview

We are looking for an experienced Prior Authorisation Specialist to join our growing U.S. Healthcare RCM team.

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 email on hr@5tekmedical.com

Job Type: Full-time

Benefits:

• Health insurance
• Paid time off
• Provident Fund

Work Location: In person