Prior Authorization Executive

As a Prior Authorization Executive in the Voice Process, your role will involve verifying insurance eligibility and benefit levels to ensure adequate coverage for identified services prior to receipt. You will also be responsible for patient's cost estimation calculation. Your key responsibilities will include: - Reviewing and processing pre-authorization requests for medical services, procedures, and treatments according to established guidelines and procedures. - Obtaining prior authorization approval from insurance firms and nurse managers. - Appealing to insurance companies after prior authorization refusals. - Documenting account activity using correct medical and billing codes. - Interacting with insurance reps to follow-up on appealed authorizations. - Calling insurances on claims resolutions and handling denials for closure. To excel in this role, you should possess the following qualifications: - Excellent verbal and written communication skills. - Good analytical and resolution skills are preferred. - Willingness to work in the Night shift / Eastern Time Zone. - Strong reporting skills. - Experience in appeals, refiling, and denial management. - Meeting quality and productivity standards. In addition to the job responsibilities and qualifications, the company is in the IT Services and IT Consulting industry and offers full-time employment opportunities.,