Prior Authorization & Referral Specialist Medications

Staffingly, Inc.; Hyderabad; In loco; INR 600.000 - 900.000; Tempo pieno

Descrizione del lavoro

Staffingly, Inc. in Hyderabad, India is seeking a healthcare professional to manage prior authorizations, referrals, and RCM tasks, ensuring timely approvals and accurate documentation.

You will collaborate with insurers, providers, and patients, utilize CoverMyMeds and EHR systems, and maintain HIPAA-compliant records while tracking authorization workflows from submission to completion.

Competenze

• 1+ year of experience in Prior Authorization, Referral Coordination, or Healthcare RCM.
• Experience with CoverMyMeds, EHR systems, and payer portals.
• Knowledge of medication authorization workflows and insurance processes.

Mansioni

• Process medication prior authorizations using CoverMyMeds and payer portals.
• Review patient records, clinical documentation, and insurance requirements.
• Follow up on pending, approved, and denied authorizations.
• Coordinate patient referrals and track referral status through completion.
• Communicate with insurance companies, provider offices, specialists, and patients.
• Maintain accurate documentation in EHR systems and tracking tools.
• Ensure HIPAA compliance and data confidentiality.

Conoscenze

Prior Authorization

Referral Coordination

Healthcare RCM

Strumenti

CoverMyMeds

EHR systems

Payer portals

Descrizione del lavoro

Role & responsibilities

• Process medication prior authorizations using CoverMyMeds and payer portals.
• Review patient records, clinical documentation, and insurance requirements.
• Follow up on pending, approved, and denied authorizations.
• Coordinate patient referrals and track referral status through completion.
• Communicate with insurance companies, provider offices, specialists, and patients.
• Maintain accurate documentation in EHR systems and tracking tools.
• Ensure HIPAA compliance and data confidentiality.

Preferred candidate profile

• 1+ year of experience in Prior Authorization, Referral Coordination, or Healthcare RCM.
• Experience with CoverMyMeds, EHR systems, and payer portals.
• Knowledge of medication authorization workflows and insurance processes.
• Strong communication, organizational, and follow-up skills.
• Familiarity with HIPAA and healthcare documentation standards.