Process Executive

Job Description

Job Description Company Description Omnia Management Services, a Surat-based company dedicated to revolutionizing the operational efficiency of Home Health Agencies across the USA. At Omnia, we specialize in providing comprehensive outsourcing services, focusing on scheduling, insurance authorization, and related functions to elevate the healthcare experience. Role Description This is a full-time, in office role located in Surat for a Process Executive . The Process Executive will be responsible for managing patient insurance authorizations, verifying insurance eligibility, ensuring compliance with all laws and regulations, and overseeing the validation and follow-up of missed visits. Additionally, this specialist will work closely with other healthcare professionals to manage patient care effectively and efficiently. Responsibilities Review and verify medical documentation and insurance coverage to assess the necessity of pre-authorization. Communicate effectively with healthcare providers to gather all required information and documentation for pre-authorization requests. Submit pre-authorization requests to insurance companies and diligently track their status. Follow up with insurance companies to ensure prompt approval or resolution of pre-authorization requests. Maintain accurate records of all pre-authorization activities and update relevant databases accordingly. Collaborate with healthcare providers and insurance companies to address any issues or concerns related to pre-authorization. Stay updated with insurance policies, guidelines, and industry trends pertaining to pre-authorization processes. Verify patient insurance eligibility and benefits. Meet the productivity and quality metrics set by the company. Check on missed visits. Ensure that missed visits are for a valid reason. Inform concerned department, if missed visits are not for a valid reason so they can follow up with the patient and confirm the reason. Notify the concerned department if the patient is transferred to the hospital for them to follow up. Follow up on past due notes needed to request authorization. Qualifications Bachelor Degree or equivalent experience (healthcare-related field is preferred but not required) Prior experience in healthcare insurance coordination, especially managing prior authorizations (Preferred but not required) Strong knowledge of insurance regulations and requirements (prefered but not required) Excellent communication and interpersonal skills Strong attention to detail and organization skills Ability to multitask and manage time effectively in a fast-paced environment Proficiency with Microsoft Office and other relevant software If you are a motivated and detail-oriented individual with a genuine passion for healthcare, we encourage you to seize this exciting opportunity by applying today. Please submit your resume, highlighting your relevant experience and skills. We welcome individuals who possess a willingness to learn and grow with us, as the right candidate will receive comprehensive training. Job Types: Full-time, Permanent Pay: ₹20,000.00 - ₹25,000.00 per month Schedule: Day shift Weekend availability Ability to commute/relocate: Athwa, Surat, Gujarat: Reliably commute or planning to relocate before starting work (Required) Location: Athwa, Surat, Gujarat (Required) Work Location: In person