174 Prior Authorization Jobs - Page 3

Comapny - Pacific Access Healthcar Location - Noida Position - Executive / Sr Executive Contact - 9311316017 (WhatsApp & call ) Roles and Responsibilities Obtain prior authorizations from payers according to established guidelines. Follow up on outstanding prior authorizations until approvals are received. Ensure accurate coding of authorization requests and maintain records accordingly. Collaborate with healthcare providers to resolve billing discrepancies related to prior authorizations. Desired Candidate Profile 1-5 years of experience in Prior Authorization, US Healthcare, RCM (Revenue Cycle Management), or similar roles. Strong understanding of authorization processes and regulations. Excellent communication skills for effective collaboration with healthcare providers and payers. Ability to work independently with minimal supervision while meeting productivity targets. Interested candidates can share their resumes on Manish.singh2@pacificbpo.com or call on 9311316017 (HR Manish Singh) .

Job Title: Prior Authorization (voice process) Company: Vee Healthtek Pvt Ltd Locations: Chennai Job Type: Full-time Salary: Competitive (based on experience) Benefits: 1200 Allowances, 1200 Food Card & Two-way Cab Key Responsibilities: • Review and process prior authorization requests for medical treatments and services. • Communicate with insurance companies to ensure timely approvals. • Work closely with healthcare professionals to gather necessary documentation. • Maintain accurate records and follow up on pending authorizations. • Ensure compliance with healthcare regulations and company policies. Who Can Apply? • AR Caller Prior Authorization: 1 year of experience in healthcare AR calling. • Senior AR Caller Prior Authorization: Minimum 2+ years of experience in AR calling with expertise in claim resolution. • Strong understanding of US healthcare revenue cycle management. • Excellent communication and analytical skills. • Ability to work night shifts and meet performance targets. If your interested in joining our team, please reach out to Vinith R at 9566699374 or email your resume to vinith.ra@veehealthtek.com. We look forward to welcoming you to Vee Healthtek Pvt Ltd!!!!

Comapny - Pacific Access Healthcar Location - Noida Position - Executive / Sr Executive Contact - 9891404338 / 7303413866 (Whatsapp & call ) Roles and Responsibilities Obtain prior authorizations from payers according to established guidelines. Follow up on outstanding prior authorizations until approvals are received. Ensure accurate coding of authorization requests and maintain records accordingly. Collaborate with healthcare providers to resolve billing discrepancies related to prior authorizations. Desired Candidate Profile 1-5 years of experience in Prior Authorization, US Healthcare, RCM (Revenue Cycle Management), or similar roles. Strong understanding of authorization processes and regulations. Excellent communication skills for effective collaboration with healthcare providers and payers. Ability to work independently with minimal supervision while meeting productivity targets. Interested candidates can share their resumes on Manish.singh2@pacificbpo.com or call on 9311316017 (HR Manish Singh) .

Role & responsibilities Review and process prior authorization requests in a timely and accurate manner. Communicate with healthcare providers, insurance companies, and patients to obtain necessary information and documentation. Ensure compliance with all regulatory and company policies and procedures. Maintain accurate records of all prior authorization activities and decisions. Provide support and guidance to healthcare providers and patients regarding prior authorization requirements and processes. Collaborate with other team members to improve workflow and efficiency. Stay updated on industry trends, regulations, and best practices related to prior authorization and healthcare operations. Preferred candidate profile B.Pharma/M.Pharma qualified candidates with 1 year of health care operations experience can apply. Perks and Benefits # Salary up to 5.8lpa # Both way cabs. # Rotational Shifts. # Top most brand name. # Good career growth. # and many more benefits. If interested then whats app your resume or call @ Gautam- 8800499244 OR Itisha- 99900 52966

As a Technical Lead - RPA at CitiusTech, you will be part of an Agile team responsible for designing and building healthcare applications, implementing new features, and ensuring adherence to the best coding development standards. Your primary responsibilities will include: - Developing RPA code in compliance with client's coding standards, minimizing the need for major code reviews and handholding. - Ensuring that coding standards applicable to the Customer environment are strictly followed. - Conducting peer reviews, providing feedback on coding, testing, and documentation. - Managing UAT defects to facilitate the smooth transition of bots from UAT to Pre-Prod and then to Prod. - Creating deployment plans for GoLive post UAT completion. - Collaborating with other developers throughout the implementation lifecycle. - Creating reusable and modular functions, supporting software development activities. - Ensuring the development team performs timely backups of fully functional code and securely stores backups in alignment with Environment Standards and Compliance. - Taking inputs from RPA stakeholders and ensuring Developers adhere to up-to-date standards and practices. Required Experience: - 7-8 years of relevant experience. Location: - Mumbai, Pune, Chennai, Bangalore. Educational Qualifications: - Engineering Degree - BE/ME/BTech/MTech/BSc/MSc. - RPA Developer advanced certification. - Technical certification in multiple technologies is desirable. Mandatory Technical Skills: - Minimum 3+ years of experience in Power Automate. - Proficiency in web and desktop automation. - Experience in Excel Automation and Orchestrator understanding (Assets, Configuration). - Familiarity with API calls through Power Automate. - Basic knowledge and experience in Tableau and Looker. - Hands-on experience in Power Automate Desktop and Cloud. - Understanding of AI Builder, Standard and Premium Connectors. - Working experience in US healthcare in at least one of the RCM processes (Claims/Pre adjudication/Prior authorization/Denials etc.). Good to Have Skills: - Quick learner with adaptability to change. - Attention to detail and quality consciousness. At CitiusTech, we are committed to combining IT services, consulting, products, accelerators, and frameworks with a client-first mindset and next-gen tech understanding to humanize healthcare and make a positive impact on human lives. Our culture focuses on creating a fun, transparent, non-hierarchical, diverse work environment that promotes continuous learning and work-life balance. Our EVP, "Be You Be Awesome," reflects our dedication to creating a workplace where employees can thrive personally and professionally. We offer comprehensive benefits to support your long and rewarding career with us. Join us in solving healthcare challenges and positively impacting human lives alongside global leaders. For more information about CitiusTech, visit https://www.citiustech.com/careers and follow us on [Social Media Platforms]. Happy applying!,

Hiring for Healthcare authorization Need B.pharma & M.Pharma pass with 1yr exp in medical scribe, authorization, summarization Loc Gurgaon Salary upto 5.80LPA 5 Days working Rotational shift/OFF Snehal 9625998099 Lakshita 8595954721 Divya 9910810424 Required Candidate profile Candidates must have Good communication skills. Candidates must be comfortable working in any shifts.

Review Google for missing data elements. Initiate request for medical via system. Ability to prioritize and maintain quality. Clear and accurate written and verbal communication (Scripted and Templatized) with stateside Required Candidate profile Knowledge about the Insurance industry in US Knowledge about US Culture Knowledge of Insurance principles Knowledge of Disability domain interpret business documents. Good verbal comms

We're Hiring ! Looking to grow your career in healthcare operations? Eligibility Verification Benefits Verification Prior Authorization Eligibility Criteria : Minimum 1+ year of RCM experience Immediate joiners preferred What We Offer: Attractive Incentives 5-Day Work A dynamic, growth-focused work environment Walk-In Drive | Mohali | DM to apply or walk in directly! Hemalatha HR -7200053787 hemalatha.bjobixoindia.com

We Are Hiring AR Caller / Prior Authorization / EVBV / Medical Billing Professionals Locations : Hyderabad | Mumbai | Chennai Work Mode : Work From Office Open Positions : AR Caller Prior Authorization (Prior Auth) EVBV Medical Billing Eligibility Criteria : Minimum Experience : 1+ Year (Mandatory) Education : Graduation (Mandatory) Relieving Letter : Mandatory Salary Package (Based on Current CTC) : AR Calling : Up to 4.2 LPA Prior Authorization : Up to 4.6 LPA EVBV : Up to 4.6 LPA Medical Billing : Up to 4.3 LPA Perks & Benefits : Cab Facility Provided Notice Period up to 60 Days Accepted ( Only for Mumbai Location) Fixed night shift{6:30pm-3:30am} Note : Immediate joiners will be preferred INTRESTED CANDIDATES CAN SHARE YOUR RESUMES Contact HR Aasritha:-91541 77391 Mail:- aasrithahr.axis@gmail.com REFERENCES ARE HIGHLY PREFFERED

Job highlights Minimum 1+ years' experience in Pre-Authorization with Surgery/Orthopedic experience and good understanding of medical terminology Obtain prior authorizations and referrals from insurance companies, monitor and update orders, provide clinical information for authorizations Job description **Please Ignore if you have experience into NON VOICE**Minimum 1+ years' experience in Pre-Authorization (RCM) Voice Process.Role & responsibilitiesObtains prior-authorizations and referrals from insurance companies prior to procedures or Surgeries utilizing online websites or via telephone.Monitors and updates current Orders and Tasks to provide up-to-date and accurate information.Provides insurance company with clinical information necessary to secure prior-authorization or referral.Obtains and/or reviews patient insurance information and eligibility verification to obtain prior authorizations for injections, DME, Procedures, and surgeries.Preferred candidate profile Role Prerequisites: Minimum 1 year and above experience in Prior Authorization with Surgery/Orthopedic Experience Good understanding of the medical terminology and progress notes How to Apply:Contact Person: Venkatesh R (HR)Phone Number: 8762650131 (Call or WhatsApp)Email: Venkatesh.ramesh@omegahms.comLinked in : https://www.linkedin.com/in/venkatesh-reddy-01a5bb112/ This opportunity is a work-from-office (WFO) position based in Bangalore.RegardsVenkatesh Rhttps://www.linkedin.com/in/venkatesh-reddy-01a5bb112/HR TEAM

Location Hyderabad & work from office only Job highlights Minimum 1+ years' experience in Pre-Authorization and good understanding of medical terminology Obtain prior authorizations and referrals from insurance companies, monitor and update orders, provide clinical information for authorizations Job description **Please Ignore if you have experience into NON VOICE** Minimum 1+ years' experience in Pre-Authorization (RCM) Voice Process. Role & responsibilities Obtains prior-authorizations and referrals from insurance companies prior to procedures or Surgeries utilizing online websites or via telephone. Monitors and updates current Orders and Tasks to provide up-to-date and accurate information. Provides insurance company with clinical information necessary to secure prior-authorization or referral. Obtains and/or reviews patient insurance information and eligibility verification to obtain prior authorizations for injections, DME, Procedures, and surgeries. Preferred candidate profile Role Prerequisites: Minimum 1 year and above experience in Prior Authorization ( Voice Process ) Good understanding of the medical terminology and progress notes Note: Only Immediate Joiners are required, and freshers please ignore it. How to Apply Ready to take your career to the next level? Apply now! Email your resume to: Keziya.Prasadbabu@omegahms.com Call: +91 8712312855 Chat on WhatsApp: 8712312855 Regards: Keziya.A

Sutherland is hiring Immediate joiners Sutherland is seeking a skilled and experienced RCM Specialist to join our dynamic healthcare team. If you have a strong understanding of physician billing, CMS 1500, and Denial management this is the perfect opportunity to advance our career with global leader in business process transformation AR Calling - For Provider Minimum 24 Months work experience required CTC 3 LPA - 5.5 LPA Looking for Immediate joiners Physician billing, CMS 1500 End to end Denial Experience/ Modifiers/ CPT Codes Night shift/ Fixed week off Mandate WFO, no hybrid Transport radius should be 25KM Contact person: Akshaya JM Contact number: 8072294017 Quality Analyst - US Healthcare (RCM) Key Responsibilities: Monitor and evaluate calls, claims, and transactions to ensure compliance with quality standards in RCM. Conduct audits and provide feedback to improve process efficiency and accuracy. Identify areas of improvement and recommend process enhancements. Work closely with the operations team to ensure adherence to client and regulatory requirements. Prepare and present quality reports and findings. Assist in training and mentoring teams to enhance overall quality performance. Required Skills & Qualifications: Minimum 1 year of experience in US Healthcare RCM. [Not on papers will also work] Strong knowledge of medical billing, coding, and claims processing. Excellent analytical and problem-solving skills. Good communication skills (both written and verbal). Experience in quality auditing, reporting, and feedback mechanisms. Ability to work in a fast-paced environment with attention to detail. Contact person: Muskan Thakur Contact number: 9876777622 PAP - US Healthcare (RCM) Required Skills & Qualifications: Experienced into prior Authorization & Eligibility Physician billing provider side Minimum 18 months - 36 months Night Shifts Timing: 6:30 pm - 3:30 am CTC 3 LPA - 5.5 LPA Looking for Immediate joiners Mandate WFO, no hybrid Transport radius should be 25KM Contact person: Rohit Raj Payment posting Minimum 14 months - 3 years CTC 3.4 LPA - 4.8 LPA Looking for Immediate joiners Mandate WFO, no hybrid Transport radius should be 25KM Day Shift - 9:30 am - 6:30 pm Fixed shift/ Fixed week off Contact person: Akshaya JM Contact number: 8072294017 Contact person: Muskan Thakur Contact number: 9876777622 "Sutherland never requests payment or favor in exchange for job opportunities. Please report suspicious activity immediately to TAHelpdesk@sutherlandglobal.com"

AR Calling Active Openings - Cab Facility + Incentives Hyderabad , Mumbai Experience - Min 1 year into ar calling Package - Max Upto 40k Take Home Qualification - Inter & above Virtual and Walk-in Interviews Chennai Experience - Min 1.6 years into ar calling Package - Max Upto 5.5 Lpa Qualification - graduation Walk-in Interviews ( Reliving mandatory ) AR QA - Hyderabad (WFO) Experience - 5+ yrs AR + 1.5 yrs QA (on paper) or 2 yrs QA (off paper) Strong AR & QA knowledge Package - Max Upto 6 LPA | 42K TH + 2200 Allowances + Incentives Qualification - graduation Relieving letter Mandate ( 0 -10 days of notice period ) Interview - HR Virtual | Manager Face to Face Prior Authorization Openings Hyderabad Experience - Min 2 year into Prior Authorization Package - Max Upto 32k Take Home Qualification - Graduation Walk-in Interviews ( Reliving mandatory ) Mumbai Experience - Min 1 year into Prior Authorization Package : Max Upto 5.75 Lpa Qualification : Inter & above Virtual Interviews ( 2 months NP accepted ) Interested & Eligible candidates can share their resume to: HR Harshitha 7207444236 (Call / WhatsApp) harshithaaxis5@gmail.com References are appreciated

Dear Candidates , Hiring Insurance Verification (IV) Caller US Healthcare Experience Required: 14 years Work Mde- full Time Shift: Night shift The Insurance Verification (IV) Caller is responsible for contacting insurance carriers in the United States to verify patient eligibility, coverage, benefits, and authorizations. This role plays a key part in ensuring accurate billing and clean claim submissions for healthcare providers. Key Responsibilities: Call US-based insurance companies to verify patient eligibility and benefits . Gather and confirm details such as: Policy status, effective dates, and plan type (HMO/PPO/etc.) Co-pay, co-insurance, and deductible amounts Authorization or referral requirements Coverage limitations or exclusions Document verified information accurately in the EMR/EHR or client portal . Work with billing teams to ensure proper claim submission based on insurance verification. Maintain high accuracy and call handling standards to meet daily productivity targets . Handle confidential patient information in compliance with HIPAA regulations . Collaborate with team leads or QA specialists to improve process efficiency and quality. Follow-up on pending verifications as needed. Requirements: Minimum 1-4 years of experience in US healthcare voice process (insurance verification preferred). Strong knowledge of US health insurance terms and payers. Proficient in verbal English communication and active listening skills. Familiar with EMR/EHR software and insurance portals. Ability to work night shifts (US time zones). High attention to detail and data accuracy. Knowledge of HIPAA compliance and RCM cycle is a plus. Team player with problem-solving skills and willingness to learn. Interested Candidate can apply for this job Contact - 8610529763

As a Registered Nurse (RN) with active, unrestricted license in [state], your primary responsibility will be to review and assess clinical information submitted with Prior Authorization (PA) requests to determine medical necessity, appropriateness, and benefit coverage. You will conduct clinical evaluations for outpatient, inpatient, and specialty services, including J-code medications and durable medical equipment (DME) as applicable. It will be essential for you to apply CMS Medicare Advantage guidelines, internal policies, and clinical criteria (such as MCG/InterQual) to make informed decisions. Collaboration will be a key aspect of your role as you work closely with physicians, pharmacists, Utilization Management (UM) staff, and external providers to ensure accurate and timely resolution of cases. In situations involving complex or borderline cases, you will be required to escalate them to Medical Directors for a final determination. Your ability to document decisions, rationale, and communications clearly and accurately in the clinical system of record will be crucial. You will also be expected to provide support for audits, appeals, and compliance-related documentation requests, as well as participate in quality improvement initiatives and workflow optimization. Educating providers and internal teams on medical policy, coverage criteria, and regulatory requirements will be part of your regular responsibilities. To be successful in this role, you should have a minimum of 3 years of clinical experience in Utilization Management, Prior Authorization, Case Review, or related fields, along with at least 2 years of direct experience working with Medicare Advantage plans and understanding CMS requirements. Familiarity with medical management software and PA platforms, such as GuidingCare, TruCare, Epic, or similar, will be advantageous. A working knowledge of MCG/InterQual guidelines and CMS NCD/LCDs is also required. Your excellent clinical decision-making, documentation, and communication skills will be critical in this position. The ability to work independently and efficiently manage high case volumes in a fast-paced environment is essential for success. This is a full-time position with a day shift schedule. The work location is in person, and the job type is Full-time. The required experience includes 2 years of CMS Requirements and 3 years of Clinical experience.,

*** Looking for IMMEDIATE JOINER *** Job Description: We are seeking a dedicated MRI and CT Prior Authorization Specialist to join our Radiology Services team. This role is critical in ensuring prior authorizations for MRI and CT scans are obtained efficiently while maintaining close communication with physicians to secure scripts, medical records, and necessary documentation. The ideal candidate will be detail-oriented, communicative, and experienced in the U.S. healthcare and insurance systems. Key Responsibilities : Obtain prior authorizations for MRI and CT imaging procedures from insurance providers. Contact physicians and healthcare providers to request scripts, medical records, and supporting documentation for authorization submissions. Submit accurate and timely prior authorization requests, following payer-specific guidelines. Follow up with insurance companies to resolve denials, appeals, or additional information requests. Collaborate with radiology teams and billing departments to ensure proper coding (e.g., CPT/ICD-10). Maintain detailed records of authorization statuses in electronic health record (EHR) systems. Keep physicians and staff informed of authorization progress and requirements. Stay current on insurance policies, radiology procedures, and compliance standards (e.g., HIPAA). Provide exceptional support to patients regarding authorization inquiries. Qualifications: High school diploma or equivalent required; degree in healthcare administration or related field preferred. Minimum of 2 years of experience in prior authorization or radiology services. Strong understanding of MRI and CT procedures and medical terminology. Proven ability to communicate effectively with physicians and insurance representatives. Familiarity with U.S. insurance processes (e.g., Medicare, Medicaid, private insurers). Proficiency in EHR/EMR systems and Microsoft Office Suite. Excellent organizational skills and the ability to manage multiple priorities. Preferred Skills: Certification in medical billing/coding (e.g., CPC, CPB) is a plus. Experience with radiology-specific software (e.g., RIS, PACS) is advantageous.

We Are Hiring Prior Authorization Executive | Hyderabad & Mumbai(WFO) Location: Hyderabad Work From Office Shift: Fixed Night Shift Cab: 2-Way Transportation (Within 25 KM Radius) Job Requirements: • Minimum 2+ Years of Experience in Prior Authorization • Degree Mandatory • Relieving Letter Mandatory Salary Details: • CTC: Up to 5.5 LPA • Take-Home: Up to 35,000 (30% Hike on Current Take-Home) • Shift Allowance: 2,200 We Are Hiring AR QA :- Exp :- Min 5+ yrs exp in AR Calling & 1.5 Years On Papers Experience As a QA OR 2 Years Off papers exp in Mandate to have Location :- Hyderabad Package :- Up to 6 LPA & 42K TH + 2200 Allowances 2 Way Cab Must Haves :- Degree with all docs & Relieving Letter WFO Notice Period :- 0 to 10 Days Interested? Please share your updated resume with: HR Swetha – 9059181703 Mai ID - nsweta.axis@gmail.com References Are Welcome!

AR CALLING ACTIVE VACANCIES Hyderabad Experience - Min 1 year into AR Calling Package - Max Upto 40k Take Home Qualification - Inter & Above Virtual Interviews Mumbai Experience - Min 1 year into AR Calling Package - Max Upto 40k Take Home Qualification - Inter & Above Virtual and Walk-in Interviews Chennai Experience - Min 2 years into AR Calling Package - Max Upto 5.5lpa Qualification - Graduation Virtual Interviews ( Reliving mandatory ) PRE AUTHORIZATION ACTIVE VACANCIES Hyderabad Experience - Min 2 years into Prior Authorization Package - Max Upto 5.5 Lpa Qualification - Graduation Reliving mandatory Walk-in Interviews Mumbai Experience - Min 1 year into Prior Authorization Package : Max Upto 5.75 Lpa Qualification : Inter & Above Virtual Interviews 2 months NP accepted ( Reliving mandatory ) Interested candidates can share your updated resume to: HR Dharani 9100982938 (WhatsApp) Mail ID: dharanipalle.axishr@gmail.com Refer your friends and Colleagues!

Job Title: EV Caller Location: Noida Shift: Night Shift Experience Required: 3-5 Years Job Description: The EV (Eligibility & Verification) Caller is responsible for verifying patients' insurance coverage by calling insurance providers or using online portals. They ensure accurate recording of policy details, coverage limits, co-pays, deductibles, and benefit information.The Authorization Specialist secures prior authorizations for medical services by coordinating with payers and providers. They follow up on pending requests and ensure all approvals are in place before patient services are rendered. Key Responsibilities: Contact insurance companies to verify patient benefits and eligibility Document insurance responses accurately in the system Identify and obtain required prior authorizations for procedures Follow up on authorization requests and escalate when necessary Maintain compliance with HIPAA and organizational policies Coordinate with internal teams to resolve insurance or authorization issues Contact Person: HR - S.Revathi Contact Number: 9354634696

Huge openings for AR Callers at Chennai and Bangalore. WORK FROM OFFICE Only. 50+ openings for AR Callers Min 1 year experience in Denial management & Healthcare is must. Physician and Hospital billing. AR Caller - Day & Night shift, Chennai & Bangalore. Authorization Caller - Night shift, Chennai. Pre-authorization Caller - Night shift, Bangalore. Rounds of Interview: Only one technical round. Shift Timing: Night Shift & Day shift Pick up and drop facility at door step. Location: Chennai and Bangalore. Interview Mode: Virtual only (Online video call) Salary: Best in the Market + Incentive + Every 3 months once appraisal. Immediate joiners are preferred. Kindly reach out to Rajesh @ 8667472289 (WhatsApp) or rajesh.sairam@globalconnectsolution.in Note: Kindly message on WhatsApp if i am not answered. Please share it to your friends, colleague and groups, it may help some one.

Walk-In Drive | Mohali | 21st26th July We’re hiring professionals from RCM for: Eligibility Verification & Benefits Verification Prior Authorization Location: Mohali, Punjab Experience: Min 1 Year | Job Summary: We are hiring skilled RCM professionals for our **Mohali office** to handle Eligibility & Benefits Verification and Prior Authorization tasks. Join us to grow your healthcare career and make an impact! Key Responsibilities: * Verify patient insurance eligibility and benefits via payor contact/portals. * Initiate and complete prior authorization requests for medical services. * Follow up with insurance companies on approval/denial status. * Document authorization details accurately in systems. * Analyze medical records to interpret diagnoses and treatment plans. * Resolve discrepancies and escalate complex cases. * Ensure timely completion of tasks with quality compliance. Requirements: * Minimum 1 year RCM experience in EVBV or Prior Authorization. * Strong communication & analytical skills. * Flexible to work night shifts. Work Location: Mohali, Punjab Contact: HR Suraj Gupta | 8898807421 Apply now or walk in directly!

Location: Chennai, Bangalore, Hyderabad, Pune & Baroda Work Mode : Hybrid Exp : 10+ Yrs Looking for Immediate to 15 Days joiners only, since we are planning to kick start this project by Aug 1st week. We are seeking a detail-oriented and proactive End-to-End Test lead, preferably 12+ years with strong expertise across Member Enrollment, Claims, Prior Authorization, Encounters and Care Management domains in the US healthcare ecosystem. The ideal candidate is an independent thinker , able to design and execute test strategies, ensuring comprehensive coverage and quality in complex healthcare systems. Key Responsibilities: Develop, execute, and maintain end-to-end test scenarios spanning multiple healthcare domains (Member, Enrollment, Claims, Prior Auth, Encounters, Care Management). Collaborate with Business Analysts, Product Owners, and Stakeholders to understand requirements and translate them into comprehensive test strategies. Conduct functional, integration, regression, and UAT support testing across cross-functional modules. Validate data flow across systems (EDI, downstream platforms, provider/member portals, etc.) and ensure alignment with business rules. Identify data requirements and create test data (including mock EDI files like 834, 837, 278, etc.). Drive root cause analysis of issues and work independently to resolve or escalate with minimal dependency on development teams. Ensure compliance with HIPAA and industry standards across testing activities. Participate in Agile ceremonies, providing test status, risk assessment, and quality insights. Required Skills: Strong domain expertise in US Healthcare : Member Management, Enrollment (834), Claims (837P/I), Prior Authorization (278), Encounters and Care Management workflows. Hands-on experience with EDI formats , healthcare platforms, and data validation tools. Proven ability to work independently , drive testing strategy, and challenge assumptions. Experience with tools such as JIRA, qtest, ADO, SQL, Postman , and test automation basics (TOSCA, optional but a plus). Strong communication and analytical skills to work across cross-functional teams. Ability to troubleshoot data and integration issues across APIs, DBs, and EDI feeds.

Locations: Chennai, Trichy, Mumbai Experience: 1-5 years Skills: AR calling, denial management, prior authorization (physician/hospital billing) Shift: Voice process (typically EST night shift) Joining: Immediate intake preferred

Locations: Chennai, Trichy, Mumbai Experience: 1–5 years Skills: AR calling, denial management, prior authorization (physician/hospital billing) Shift: Voice process (typically EST night shift) Joining: Immediate intake preferred

Eligible Candidate must have worked for EVBV or Pre Auth. US Healthcare - Provide Side Exp is mandatory Shift - 5.30pm to 2.30am both side cab facilities available 5 days working in a week Sat & Sun fixed OFF