Job Title: Authorization Specialist
Department: Knowledge Process Outsourcing (KPO)
Domain: Healthcare
Location: Bangalore, India
Salary: 45,000 - 60,000 per month
Job Summary:
We are seeking an experienced Authorization Specialist to join our healthcare team in Bangalore. The role requires strong knowledge of medical insurance processes, including CPT and ICD-10 coding, with a primary focus on managing prior authorizations for medical procedures. The ideal candidate will be detail-oriented, have excellent communication skills, and be able to work efficiently under pressure.
Key Responsibilities:
- Review and Verification
- Assess patient medical history and related documentation to determine the necessity for prior authorizations.
- Review insurance coverage for patients and verify eligibility.
- Ensure familiarity with CPT and ICD-10 coding for accurate processing.
- Insurance Coordination
- Confirm insurance benefits and regularly communicate with insurance companies to submit and manage prior authorizations.
- Utilize insurance carrier websites and portals (e.g., Evicore, Availity, Cohere) for submitting necessary documents efficiently.
- Monitor daily authorization status and follow up on pending authorizations by contacting insurance providers as needed.
- Documentation and Follow-Up
- Submit appeals for denied authorizations and schedule peer-to-peer calls when required.
- Coordinate with insurance providers to extend authorization dates, request additional units, and process urgent or priority authorizations.
- Accurately document authorization details, approvals, and denials in the Electronic Health Record (EHR) system (e.g., ECW).
- Communication and Issue Resolution
- Maintain clear communication with healthcare providers, insurance companies, and patients regarding the authorization process and status.
- Monitor the patient schedule for potential issues and promptly address them with the healthcare office if needed.
- Respond to calls and correspondence related to patient accounts, providing resolution to inquiries and issues.
Requirements:
- Education: Graduate degree in a relevant field (Healthcare Administration, Life Sciences, or similar).
- Experience: Proven experience in prior authorization and medical billing within the healthcare domain.
- Skills:
- Proficiency in understanding and applying CPT and ICD-10 coding.
- Strong organizational skills to track authorizations, submit appeals, and monitor schedules effectively.
- Ability to use electronic health record (EHR) systems, preferably ECW, and insurance portals.
- Excellent communication skills and the ability to handle high-pressure situations.
- Knowledge of insurance carrier policies and prior authorization procedures.
Work Conditions:
- Location: Bangalore
- Employment Type: Full-time
- Schedule: Regular working hours, with potential requirements for additional hours based on workload.
If you are detail-oriented, proactive, and capable of managing multiple priorities, we encourage you to apply for this role.
Application Process:
Please submit your resume along with a cover letter detailing your experience in healthcare authorization to [Your Companys Email/HR Contact].
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Job Title: Authorization Specialist
Department: Knowledge Process Outsourcing (KPO)
Domain: Healthcare
Location: Bangalore, India
Salary: 45,000 - 60,000 per month
Job Summary:
We are seeking an
experienced Authorization Specialist to join our healthcare team in
Bangalore. This role requires strong knowledge of
medical insurance processes, including
CPT and
ICD-10 coding, with a primary focus on managing
prior authorizations for medical procedures. The ideal candidate will be
detail-oriented, have
excellent communication skills, and be able to
work efficiently under pressure.
Key Responsibilities:
- Review and Verification
- Assess patient medical history and related documentation to determine the necessity for prior authorizations.
- Review insurance coverage for patients and verify eligibility.
- Ensure familiarity with CPT and ICD-10 coding for accurate processing.
- Insurance Coordination
- Confirm insurance benefits and regularly communicate with insurance companies to submit and manage prior authorizations.
- Utilize insurance carrier websites and portals (e.g., Evicore, Availity, Cohere) for submitting necessary documents efficiently.
- Monitor daily authorization status and follow up on pending authorizations by contacting insurance providers as needed.
- Documentation and Follow-Up
- Submit appeals for denied authorizations and schedule peer-to-peer calls when required.
- Coordinate with insurance providers to extend authorization dates, request additional units, and process urgent or priority authorizations.
- Accurately document authorization details, approvals, and denials in the Electronic Health Record (EHR) system (e.g., ECW).
- Communication and Issue Resolution
- Maintain clear communication with healthcare providers, insurance companies, and patients regarding the authorization process and status.
- Monitor patient schedules for potential issues and promptly address them with the healthcare office if needed.
- Respond to calls and correspondence related to patient accounts, providing resolution to inquiries and issues.
Requirements:
- Education: Graduate degree in a relevant field (Healthcare Administration, Life Sciences, or similar).
- Experience: Proven experience in prior authorization and medical billing within the healthcare domain.
- Skills:
- Proficiency in CPT and ICD-10 coding.
- Strong organizational skills to track authorizations, submit appeals, and monitor schedules effectively.
- Ability to use Electronic Health Record (EHR) systems, preferably ECW, and insurance portals.
- Excellent communication skills and the ability to handle high-pressure situations.
- Knowledge of insurance carrier policies and prior authorization procedures.
Work Conditions:
- Location: Bangalore candidates only
- Employment Type: Full-time
- Schedule: Regular working hours, with potential requirements for additional hours based on workload.
If you are
detail-oriented, proactive, and capable of
managing multiple priorities, we encourage you to apply for this role.
Application Process:
Please submit your resume along with a cover letter detailing your experience in
healthcare authorization to
[HIDDEN TEXT] or contact us at
9063238178.
