Team Lead - Prior Authorization (Bangalore)

Omega Healthcare; Bengaluru; On-site; INR 1,500,000 - 2,500,000; Full time

Job summary

Omega Healthcare in Hyderabad is seeking an experienced Prior Authorization Lead to manage the PA operations for US healthcare processes. You will lead a team, ensure timely submissions and monitor SLA adherence.

The role requires 6+ years in US healthcare, 1 year in team lead, knowledge of payer guidelines and HIPAA; graduation is mandatory. Night shift and on-site work in Hyderabad are required.

Qualifications

• 6+ years of experience in US healthcare processes
• Team Lead experience (on paper)
• Experience with Prior Authorization workflows
• Eligibility and Benefits Verification experience
• HIPAA compliance knowledge

Responsibilities

• Lead and manage Prior Authorization operations.
• Ensure timely and accurate submission of authorizations.
• Handle team performance, reviews, and escalations.
• Participate in client calls and ensure SLA compliance.
• Track key metrics like approval rates and turnaround time.

Skills

Prior Authorization

Team Lead

US Healthcare

Payer Guidelines

HIPAA Compliance

Client Communication

Performance Tracking

Education

Graduation

Tools

EHR/EMR Systems

Payer Portals

Job description

Key Responsibilities:

• Lead and manage Prior Authorization operations.
• Ensure timely and accurate submission of authorizations.
• Handle team performance, reviews, and escalations.
• Participate in client calls and ensure SLA compliance.
• Track key metrics like approval rates and turnaround time.

Skills Required:

• Minimum 6+years of experience in US healthcare processes, with at least 1 years in a Team Lead role (on paper) for Prior Authorization
• Strong knowledge of Prior Authorization workflows, payer guidelines, and pre-cert requirements
• Add-on experience in Eligibility and Benefits Verification is a strong advantage
• Excellent communication and interpersonal skills must be comfortable leading client discussions
• Strong team management, performance tracking, and escalation handling skills
• Familiarity with EHR/EMR systems and payer portals.

Good to Have:

• Knowledge of insurance plans (Commercial, Medicare, Medicaid)
• Experience in handling multi-specialty authorizations (Radiology, Surgery, DME, etc.)
• Exposure to quality metrics and reporting tools
• Understanding of HIPAA and compliance regulations

Graduation Mandatory.

Location: Hyderabad (On-site)

Shift: Night Shift