Walk-in | Associate/Professional, Prior Authorization

Advantum Health; Hyderabad; Sur place; INR 600 000 - 1 200 000; Plein temps

Résumé du poste

Advantum Health is seeking a detail-oriented Authorization Specialist in Hyderabad to manage and streamline the insurance authorization process. The role focuses on timely and accurate authorizations while adhering to payer guidelines and HIPAA requirements.

The ideal candidate will have 1+ year of Prior Authorization experience and will collaborate with physicians, clinical staff, and payers to secure approvals efficiently and maintain thorough documentation.

Qualifications

• 1+ years in Prior Authorization (RCM).
• Focus on timely and accurate insurance authorizations in line with payer guidelines.

Responsabilités

• Manage end-to-end insurance authorization processes including pre-certifications, prior authorizations and pre-determination.
• Review clinical documentation to ensure it meets payer-specific requirements.
• Coordinate with physicians, clinical staff, insurance providers, and internal teams to obtain approvals.
• Track authorization status and follow up with payers to prevent delays or denials.
• Maintain accurate documentation and update authorization details in internal systems.
• Identify and escalate authorization-related issues or risks in a timely manner.
• Ensure compliance with HIPAA regulations and organizational policies.

Description du poste

Job Description

We are seeking a detail-oriented Authorization Specialist to manage and handle the authorization process. The ideal candidate will ensure timely and accurate insurance authorizations while maintaining compliance with payer guidelines and client requirements.

Experience

1+ years in Prior Authorization (RCM)

Key Responsibilities

• Manage end-to-end insurance authorization processes including pre-certifications, prior authorizations and Pre-determination.
• Review clinical documentation to ensure it meets payer-specific requirements.
• Coordinate with physicians, clinical staff, insurance providers, and internal teams to obtain approvals.
• Track authorization status and follow up with payers to prevent delays or denials.
• Maintain accurate documentation and update authorization details in internal systems.
• Identify and escalation authorization-related issues or risks in a timely manner.
• Ensure compliance with HIPAA regulations and organizational policies.