About the Role:

We are looking for a result-oriented Pre-Authorization Manager for a leading US Healthcare company

Key Responsibilities:

Operational Oversight

- Manage end-to-end Prior Authorization workflows, from initial request to final approval.
- Ensure timely processing of authorizations with high accuracy and compliance standards.

Team Management
- Lead and mentor a team of Assistant Managers and Team Leaders.
- Drive operational performance metrics and KPIs.
- Conduct regular performance reviews and process improvement initiatives.

Compliance
- Stay updated with CMS guidelines, CPT/ICD-10 coding changes, and payer-specific medical policies.
- Ensure adherence to HIPAA and other US healthcare regulatory standards.

Denial Strategy
- Analyze trends related to Authorization Required denials.
- Implement proactive root-cause analysis and preventive action plans to reduce denials.

Desired Candidate Profile

- 10 to 14 years of experience in:





- Prior Authorization

- Eligibility Verification

- Insurance Verification

- Related US Healthcare processes
- Solid understanding of US healthcare regulations and industry standards, including HIPAA.
- Excellent analytical and problem-solving skills.
- Ability to interpret complex operational data and identify improvement areas.
- Hands-on experience with Electronic Health Record (EHR) systems such as Epic Systems or similar platforms.

Designation Criteria

Candidates should currently be

- In a Deputy Manager role for at least 1 year, OR
- In an Assistant Manager role for 2+ years

How to Apply: Interested candidates meeting the above criteria can share their updated CV

Contact Details

Email: [email protected]

WhatsApp: (phone hidden)

📌 Manager - Prior authorization (US Healthcare) (Hyderabad)
🏢 TalentQ Solutions
📍 Hyderabad