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:

1. 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.
- Solid 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 [email protected] or contact us at (phone hidden).

📌 Authorization Specalist (Bengaluru)
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📍 Bengaluru