2 - 4 years

0 Lacs

Posted:5 days ago| Platform: Naukri logo

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Job Type

Full Time

Job Description

Key Responsibilities

  • Conduct prior authorization requests for medical procedures, drugs, and services.
  • Verify patient insurance eligibility and benefits using payer portals and phone calls.
  • Identify and calculate Patient responsibilities. Such as Copay, Deductibles, Co-Insurance.
  • Communicate with insurance companies, providers, and patients to resolve authorization issues.
  • Maintain accurate documentation and follow HIPAA compliance standards.
  • Collaborate with clinical and administrative teams to ensure timely approvals.

Qualifications

  • Minimum 2 years of experience in U.S. healthcare prior authorization and eligibility verification.
  • Familiarity with major insurance providers (Medicare, Medicaid, commercial payers).
  • Proficiency in using EMR & EHR systems and payer portals.
  • Strong communication and organizational skills.
  • Knowledge of medical terminology and coding (CPT, ICD-10) is a plus.

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