Prior Authorization Executive

Job description

Role - Prior Authorization Executive- Voice Process.

Exp - 1-2 Yrs

Location - Mysore

Verifies insurance eligibility and benefit levels to ensure adequate coverage for identified

services prior to receipt, patient's cost estimation calculation.

Review and process pre-authorization requests for medical services, procedures, and

treatments according to established guidelines and procedures

Get prior authorization approval from insurance firms and nurse managers

Appeal insurance companies after prior authorization refusals.

Get prior authorization approval from insurance firms and nurse managers.

Document account activity using correct medical and billing codes.

At least 1 year of experience in obtaining prior authorization.

Interact with the insurance rep to follow-up on appealed authorizations.

Calling Insurances on claims resolutions and handling the denials for a closure

Qualifications:

Excellent verbal and written communication skills

Good analytical & resolution skills preferred.

Candidate should be willing to work in Night shift / Eastern Time Zone

Strong reporting skills

Should have worked on appeals, refiling and denial management.

Meet Quality and productivity standards.

Industry

• IT Services and IT Consulting

Employment Type

Full-time