Responsible for obtaining pre-service treatment authorizations, verifying patient insurance eligibility, perks coverage, and copay requirements across major medical specialties (Orthopedics, Cardiology, Oncology, Pain Management).

Key Responsibilities:

- Contact insurance carriers to verify patient s insurance eligibility, benefits and requirements.
- Review patient s medical history and provide pertinent information for authorization requirements.
- Requires, follow up and secure prior authorizations prior to services.
- Input patient information and update system if needed.
- Monitor schedule and work with hospital to obtain authorizations for add-on procedures.
- Demonstrate and apply knowledge of medical terminology including HIPPA regulations.

- Clearly document all communications and contacts in patient s chart.
- Communicate with any trends or insurance changes among team.
- Attention to detail.
- Copying and faxing.




- Practice and adhere to the Code of Conduct philosophy Mission and Value Statement.
- Must read, understand, and adhere to all Physician Services policies and procedures.
- Other duties as assigned.

Qualifications & Requirements:

- 1+ years experience in medical prior authorization or eligibility verification.
- Familiarity with CPT surgical codes, ICD-10 medical necessity criteria, and payer portals.

- Strong organizational skills and ability to manage urgent pre-procedure requests.

Disclaimer: This job posting has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.

📌 Prior Authorization Specialist (India)
🏢 Shoreline Healthcare Technologies
📍 India