Pre-Authorization

TRIARQ Health India; Navi Mumbai; On-site; INR 300,000 - 420,000; Full time

Job summary

TRIARQ Health is a physician practice services company partnering with doctors to run patient-centered practices focused on value-based care. This full-time, in-office role in Navi Mumbai handles pre-authorization, verifying insurance, and interfacing with payers to secure approvals before procedures.

Night shifts apply due to coverage needs. The successful candidate will review medical records, submit appeals for denials, and ensure timely, accurate payer communication.

Qualifications

• At least 1 year of experience in Pre-Auth.
• Experience in medical billing and verification/authorization processes.
• Strong communication and interpersonal skills to interact with insurers.

Responsibilities

• Verify patient insurance coverage and obtain pre-authorization for procedures.
• Communicate with insurers and providers to resolve claims issues and review medical records.

Skills

Pre-Auth experience

Medical billing

Insurance verification

Communication skills

Interpersonal skills

Attention to detail

Fast-paced environment

Medical terminology

Payer guidelines

Education

HSC/Graduate

Job description

Job Description:

TRIARQ Health is a physician practice services company that partners with doctors to run modern patient-centered practices so they can be rewarded for delivering high-value care. TRIARQ's physician-led partnerships simplify practices' transition to value-based care by combining our proprietary, cloud-based practice, care management platform, and patient engagement services to help doctors focus on better outcomes.

Industry Type:

RCM / US Healthcare

Location:

Navi Mumbai (Ghansoli)

Division:

Revenue Cycle Management (RCM)

Job Responsibilities

This is a full-time work-from-office role for a pre-authorization specialist. The pre-authorization specialist will be responsible for verifying patient insurance coverage and obtaining pre-authorization for medical procedures prior to services being rendered utilizing online websites, tools, or via phone calls. The pre-authorization specialist will communicate with insurance companies and healthcare providers to resolve any issues or discrepancies in claims.

The pre-authorization specialist needs to be able to review and understand provider medical records. The pre-authorization specialist needs to be able to submit appeals for denied claims and ensure all accurate and pertinent information is provided to the payer in a timely manner.

Skills Required

• The candidate must have at least one year of experience working in the Pre-Auth department.
• The candidate must possess experience in medical billing, as well as in the verification and authorization processes of insurance.
• The candidate must possess strong communication and interpersonal skills to effectively interact with insurance companies.
• Attention to detail and ability to accurately process and manage data.
• Ability to work in a fast-paced environment and meet deadlines.
• Good understanding of medical terminology.
• Good understanding of Payer guidelines.

Education

HSC/Graduate (any stream)

Employment Type

Full Time, Permanent. Night shift.