Job description- Responsible for researching patient member benefits, additional coverages, coverage limitations, and general coverage allowances to obtain the necessary authorizations and referrals for patient services.
Initiate and manage the prior authorization process for medical procedures, treatments, or medications.- Prepare and submit prior authorization requests to insurance companies or healthcare payers according to established procedures.
Ensure all required documentation, including clinical notes, medical history, and supporting documents, are complete and accurate.
- Processes prior authorizations and referral requests in a timely manner, prior to the patient's services being rendered.
Bachelor's degree in any discipline.
- Min 1 year experience in Pre-Authorization & eligibility, benefits
Strong knowledge of medical terminology, insurance policies, and healthcare reimbursement processes.- Excellent communication, organizational, and problem-solving skills.
Ability to work independently and collaboratively in a fast-paced, deadline-driven environment.
- eClinicalWorks experience will be an added advantage.
Willing to work the night shift (any 9 hrs. between 6:30 pm 3:30 am)- Salary: as per company policy
Job Types: Full-time, Permanent
Pay: 20,- 00 - 30,000.00 per month
Benefits: - Food provided
Leave encashment
Paid time offSchedule: Night shift
Experience:
- total work: 1 year (Required)
Work Location: In person
