Prior Authorization

Job Summary:

The Prior Authorization and Eligibility Specialist is responsible for verifying patient insurance coverage, obtaining prior authorizations for medical procedures, and ensuring that services are covered under the patient’s insurance plan. This role plays a critical part in minimizing claim denials and ensuring timely reimbursement.

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Key Responsibilities:

· Verify patient insurance eligibility and benefits prior to scheduled services.

· Obtain prior authorizations and pre-certifications from insurance companies for procedures, medications, and services.

· Document all communications and authorization details in the patient’s electronic health record (EHR).

· Communicate with providers, patients, and insurance companies to resolve coverage issues.

· Monitor and follow up on pending authorizations to ensure timely approvals.

· Maintain up-to-date knowledge of insurance policies, payer requirements, and authorization processes.

· Collaborate with billing and coding teams to ensure accurate claims submission.

· Assist patients with understanding their insurance benefits and financial responsibilities.

Job Types: Full-time, Permanent

Pay: ₹25,000.00 - ₹35,000.00 per month

Schedule:

• Monday to Friday
• Night shift

Work Location: In person