15 Oct
|
ONCOSPARK
|
Madurai
Job highlights
- 1-4 years of experience in Prior Authorization,Pre-Certification,or Utilization Management (US Healthcare). Solid understanding of US insurance payers,CPTICD codes,medical necessity guidelines,and RCM workflows. Good communication skills.
- Experience with payer portals such as Availity,Optum,Aetna,etc. Ability to multitask,prioritize,and meet turnaround deadlines.
- Review clinical documents, determine authorization requirements, and submit prior authorization requests to insurance payers.
- Follow up with payers to ensure timely approvals and maintain accurate authorization records.
- Coordinate with providers to obtain required clinical information and ensure compliance with payer guidelines.
- Communicate authorization status to internal teams and support ARRCM teams to reduce authorization-related denials.
- Resolve payer issues, assist with appeals, and ensure compliance with HIPAA and organizational standards.
Skill Sets
- 1-4 years of experience in Prior Authorization , Pre-Certification, or Utilization Management (US Healthcare).
- Strong understanding of US insurance payers , CPTICD codes, medical necessity guidelines, and RCM workflows.
- Good communication skills.
- Experience with payer portals such as Availity, Optum, Aetna, etc.
- Ability to multitask, prioritize, and meet turnaround deadlines.
- Familiarity with EHR Practice Management systems is a plus.
📌 Prior Authorization (Voice Process) Professional (Madurai)
🏢 ONCOSPARK
📍 Madurai