Prior-Authorization Associates-(US Healthcare-RCM)

Promantra Synergy Solutions; Hyderabad; On-site; INR 350,000 - 550,000; Full time

Job summary

Promantra Synergy Solutions is seeking an Authorization Specialist to oversee the insurance authorization process. You will ensure timely submissions, track statuses, and secure approvals while complying with payer requirements and company policies.

Ideal candidates have 1–4 years of experience in Prior Authorization and collaborate with physicians and carriers to minimize denials. This role is based in India and offers an opportunity to contribute to efficient patient care.

Qualifications

• 1-4 years of experience in Prior Authorization.
• Knowledge of payer requirements and compliance is preferred.
• Strong organizational and documentation skills.

Responsibilities

• Manage end-to-end authorization process (pre-certifications, prior authorizations, and pre-determinations) for healthcare services and procedures.
• Review and validate clinical documentation to ensure compliance with payer-specific authorization requirements.
• Collaborate with physicians, clinical staff, insurance carriers, and internal departments to obtain timely approvals.
• Monitor authorization requests, track status, and proactively follow up with payers to minimize delays, denials, or service interruptions.
• Maintain accurate and up-to-date records of authorization activities within internal systems and databases.

Skills

Prior Authorization

Detail oriented

Job description

Job Description:

We are seeking a highly organized and detail-oriented Authorization Specialist to oversee and manage the insurance authorization process. The ideal candidate will ensure timely and accurate submission, tracking, and approval of authorizations while maintaining compliance with payer requirements, regulatory standards, and organizational policies.

Experience Required: 1-4 years of experience in Prior Authorization

Key Responsibilities:

• Manage the end-to-end authorization process, including pre-certifications, prior authorizations, and pre-determinations for healthcare services and procedures.
• Review and validate clinical documentation to ensure compliance with payer-specific authorization requirements.
• Collaborate effectively with physicians, clinical staff, insurance carriers, and internal departments to obtain timely approvals.
• Monitor authorization requests, track their status, and proactively follow up with payers to minimize delays, denials, or service interruptions.
• Maintain accurate and up-to-date records of authorization activities within internal systems and databases.
• Identify, investigate, and escalation authorization-related issues, denials, or risks to appropriate stakeholders in a timely manner.