Roles and Responsibilities

- Verify patient eligibility, benefits, and insurance coverage for ophthalmic procedures.

- Obtain prior authorizations from payers for scheduled surgeries and treatments.

- Coordinate with healthcare providers to resolve any discrepancies or issues related to medication orders, radiology results, or infusions.

- Ensure accurate documentation of all interactions with patients, physicians, and insurance companies.

- Maintain confidentiality and adhere to HIPAA guidelines throughout the process.

Desired Candidate Profile

- 1-5 years of experience in Prior Authorization (PA), Eligibility Verification (EV), Insurance Verification (IV) or RCM (Revenue Cycle Management).

- Solid understanding of Ophthalmology specialty codes (e.g., ICD-10-CM/PCS) and Medicare/Medicaid regulations.

- Proficiency in using electronic medical records systems (EMRs) such as Epic Systems or similar platforms.

- Expertise in specialty Ophthalmology | Medications | Radiology & Infusion

📌 Pri-Auth Specialist Ophthalmology | Medications | Radiology & Infusion (Hyderabad)
🏢 Staffingly
📍 Hyderabad