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Prior Authorization (Voice Process) Professional

Prior Authorization (Voice Process) Professional

1 - 4 years

|

3 - 6 Lacs

madurai tiruppur salem chennai tiruchirapalli coimbatore

Posted:Just now| Platform:

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Skills Required

voice process parking pdf compliance management systems hipaa practice management appeals us healthcare

Work Mode

Work from Office

Job Type

Full Time

Job Description

Review clinical documents, determine authorization requirements, and submit prior authorization requests to insurance payers.
Follow up with payers to ensure timely approvals and maintain accurate authorization records.
Coordinate with providers to obtain required clinical information and ensure compliance with payer guidelines.
Communicate authorization status to internal teams and support ARRCM teams to reduce authorization-related denials.
Resolve payer issues, assist with appeals, and ensure compliance with HIPAA and organizational standards.

Skill Sets

1-4 years of experience in Prior Authorization , Pre-Certification, or Utilization Management (US Healthcare).
Strong understanding of US insurance payers , CPTICD codes, medical necessity guidelines, and RCM workflows.
Good communication skills.
Experience with payer portals such as Availity, Optum, Aetna, etc.
Ability to multitask, prioritize, and meet turnaround deadlines.
Familiarity with EHR Practice Management systems is a plus.

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