Experience: Minimum 1 Year
Industry: US Healthcare
Employment Type: Full-Time

Job Summary

We are looking for a detail-oriented and proactive Prior Authorization Executive with a minimum of 1 year of experience in the US Healthcare industry. The candidate will be responsible for managing prior authorization requests, coordinating with insurance companies, verifying patient insurance coverage, and ensuring timely approval of medical procedures, diagnostic tests, and treatments. The ideal candidate should have a good understanding of US healthcare insurance processes, payer guidelines, and authorization workflows.

Key Responsibilities

- Review patient information, insurance details, and medical documentation to initiate prior authorization requests.
- Submit prior authorization requests to insurance companies.
- Follow up with insurance payers to check the status of pending authorization requests.
- Coordinate with insurance providers, healthcare professionals, and internal teams to obtain required approvals.
- Verify patient eligibility, insurance benefits, and authorization requirements.




- Ensure all authorization requests are submitted accurately and within the required timelines.
- Maintain accurate records of authorization submissions, approvals, denials, and pending cases.
- Identify authorization denials or missing documentation and coordinate for necessary corrections or resubmissions.
- Communicate authorization status updates to relevant internal departments.
- Ensure compliance with HIPAA guidelines and established healthcare procedures.

Required Qualifications & Skills

- Minimum 1 year of experience in the US Healthcare industry, preferably in Prior Authorization.
- Basic understanding of US healthcare insurance, medical billing, and payer processes.
- Knowledge of insurance eligibility, advantages verification, and authorization workflows.
- Ability to manage multiple authorization requests and meet deadlines.
- Proficiency in MS Office and basic computer applications.

Pay: From ₹15,000.00 per month

Work Location: Remote

📌 Prior Authorization Executive (India)
🏢 Ameya Health Care
📍 India