Walk-in | Prior Authorization Executive

JSD Medical Business Management Services; Hyderabad; On-site; INR 400,000 - 800,000; Full time

Job summary

JSD Medical Business Management Services in India is seeking an Authorization Specialist to support US healthcare services. You will handle prior and pre-authorization requests, ensuring precise patient data and clinical information is submitted.

The role requires meticulous follow-up on requests and strict adherence to payer guidelines. You will coordinate with internal teams to obtain records, maintain accurate authorization details, and update systems within defined timelines, ensuring

Qualifications

• Submit authorization requests with accurate patient and clinical information.
• Follow up on pending, approved, denied, and additional-information requests.
• Review and understand CPT, ICD, HCPCS codes, medical terminology, and payer guidelines.
• Coordinate with internal teams to obtain required medical records and supporting documentation.
• Maintain accurate authorization details and update the system within the required timelines.
• Maintain quality, productivity, and compliance with company and client requirements.

Responsibilities

• Handle prior authorization and pre-authorization requests for US healthcare services.
• Submit authorization requests with accurate patient and clinical information.
• Follow up on pending, approved, denied, and additional-information requests.
• Review and understand CPT, ICD, HCPCS codes, medical terminology, and payer guidelines.
• Coordinate with internal teams to obtain required medical records and supporting documentation.

Skills

CPT/ICD/HCPCS

Medical terminology

Payer guidelines

Attention to detail

Team collaboration

Job description

Role & responsibilities

Handle prior authorization and pre-authorization requests for US healthcare services.

• Submit authorization requests with accurate patient and clinical information.
• Follow up on pending, approved, denied, and additional-information requests.
• Review and understand CPT, ICD, HCPCS codes, medical terminology, and payer guidelines.
• Coordinate with internal teams to obtain required medical records and supporting documentation.
• Maintain accurate authorization details and update the system within the required timelines.
• Maintain quality, productivity, and compliance with company and client requirements.

Preferred candidate profile

0-5 Prior experience in Authorization / Pre-Authorization is preferred.

Strong attention to detail and ability to maintain accurate documentation.

Ability to work independently as well as in a team.

Good analytical and problem-solving skills.

Willingness to work in US/night shifts.

Strong understanding of medical terminology, CPT, ICD, and HCPCS codes.