Pre-Authorization Analyst & Quality Analyst & Team Leader _RCM

Talentq Solutions; Hyderabad; On-site; INR 400,000 - 800,000; Full time

Job summary

Talentq Solutions is hiring for Pre-Authorization roles in the US Healthcare RCM domain. The positions require strong knowledge of hospital/physician prior authorization processes, payer guidelines, and end-to-end workflow management.

Open roles include Pre-Authorization Analyst, QA, and Team Leader with focus on accuracy, timelines, and compliant documentation. Candidates should have 1+ years of relevant experience and graduate qualification.

Qualifications

• Minimum 1+ years of relevant experience
• Experience in Pre-Authorization is mandatory
• Quality auditing / team handling experience for TL roles

Responsibilities

• Handle prior authorization requests for hospital/physician services
• Verify insurance eligibility & benefits
• Submit authorization requests via payer portals/calls/fax
• Follow up with insurance companies for approval status
• Ensure proper documentation and compliance with payer guidelines
• Maintain TAT and productivity targets

Skills

Prior Authorization knowledge

Payer guidelines

End-to-end workflow management

Communication skills

Analytical skills

Payer portals familiarity

EMR/EHR familiarity

Medical terminology CPT/ICD

Education

Graduate in any discipline

Tools

Payer portals

EMR/EHR systems

Job description

We are hiring experienced professionals for Pre-Authorization (Prior Authorization) roles in the US Healthcare RCM domain. Candidates should have strong knowledge of hospital/physician prior authorization processes, payer guidelines, and end-to-end workflow management.

Open positions include:

• Pre-Authorization Analyst
• Quality Analyst (QA)
• Team Leader (TL)

Role & responsibilities :

For Pre-Authorization Analyst:

• Handle prior authorization requests for hospital/physician services
• Verify insurance eligibility & benefits
• Submit authorization requests via payer portals/calls/fax
• Follow up with insurance companies for approval statusEnsure proper documentation and compliance with payer guidelines
• Maintain TAT and productivity targets

Preferred candidate profile

• Strong knowledge of Prior Authorization / Pre-Certification
• Experience in US Healthcare RCM (Hospital/Physician)
• Familiarity with payer guidelines (Medicare/Medicaid/Commercial)
• Good communication and analytical skills
• Experience with payer portals, EMR/EHR systems
• Strong understanding of medical terminology & CPT/ICD codes

Eligibility Criteria:

• Minimum 1+ years of relevant experience
• Experience in Pre-Authorization is mandatory
• For QA/TL roles: Prior experience in quality auditing / team handling
• Graduate in any discipline