Prior- Authorization Specialist - Hyderabad
- Primera Medical
- 3 - 6 years
- Hyderabad
- 4 months ago
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Job Description
The Prior Authorization Specialist is a key member of the healthcare team, primarily responsible for obtaining pre-approval from insurance companies for patient medications and treatments.
This role is crucial in ensuring that patients receive the necessary healthcare services without undue delay or financial burden.
Core Responsibilities:
- Review and interpret physician orders and patient medical records to determine the necessity and accuracy of prior authorization requests.
- Contact insurance providers to verify patient coverage and benefits specific to prescribed medications and treatments.
- Submit detailed authorization requests through electronic health records (EHR) systems, online portals, or via telephone.
- Collaborate with healthcare providers to gather additional information or clarification needed for prior authorization submissions.
- Monitor and track the status of submitted authorizations, following up as necessary to resolve delays or issues that may arise.
- Communicate effectively with patients regarding the status of their authorization, including any additional information or action required on their part.
- Adhere to all healthcare regulations, including HIPAA, to ensure patient privacy and the confidentiality of medical information.
Skills and Qualifications:
- Proficiency in using medical billing software and electronic health records systems.
- Familiarity with medical terminology and understanding of ICD-10 and CPT codes.
- Strong organizational skills, with the ability to prioritize tasks in a fast-paced environment.
- Excellent communication and customer service skills, with empathetic regard for patient needs.
- Experience with multitasking and meeting strict deadlines while maintaining attention to detail.
- Ability to work independently as well as part of a team, with a commitment to collaborative problem-solving.
- Immediate joinees are preferred.
Candidates can shar their resume on ra*******i@pr************e.com/ 9154961***.
Job Classification
Industry: IT Services & ConsultingFunctional Area / Department: Healthcare & Life Sciences,
Role Category: Healthcare & Life Sciences - Other
Role: Healthcare & Life Sciences - Other
Employement Type: Full time
Contact Details:
Company: Primera MedicalLocation(s): Hyderabad
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Keyskills: prior authorization US Healthcare RCM
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