Prior Authorization

3 days ago

Gurugram, India Triple Full time

Triple

Triple is leading the way in remote work solutions, helping small and medium-sized businesses in North America build highly efficient remote teams for Administration, Customer Service, Accounting, Operations, and back-office roles. Our focus has always been on our Clients, People, and Planet, ensuring our operations contribute positively across these key areas. Distinguished by its rigorous standards, Triple excels in:

  • Selectively recruiting the top 1% of industry professionals
  • Delivering in-depth training to ensure peak performance
  • Offering superior account management for seamless operations

Embrace unparalleled professionalism and efficiency with Triple—where we redefine the essence of remote hiring.

Summary

We are seeking a highly organized and detail-oriented Prior Authorization (US Healthcare) Coordinator to join our healthcare team. The candidate will be responsible for obtaining authorizations for pain management services(medication and surgery), as well as managing referrals from primary care providers to specialists. The ideal candidate will have excellent communication and problem-solving skills, be able to work independently and as part of a team, and have experience working with pain management providers.

Job Responsibilities

  • Review pain management service requests(medication and surgery) for medical necessity and accuracy.
  • Submit authorization requests to insurance companies and follow up as necessary to ensure timely approvals.
  • Communicate with primary care providers and specialists to coordinate referrals for patients.
  • Maintain accurate and complete documentation of all authorization requests and outcomes.
  • Follow up on authorization requests and provide updates to healthcare providers and patients.
  • Communicate with insurance companies, healthcare providers, and patients to obtain additional information or clarification as needed.
  • Maintain current knowledge of insurance regulations and Prior Authorization policies and procedures.
  • Perform other duties as assigned by the supervisor.

Qualifications

  • Graduate/Post-Graduate degree/diploma
  • Minimum 2 years of work experience in a similar role
  • Excellent verbal and written communication skills
  • Effective customer relation skills
  • Ability to organize and interpret data
  • Requires good judgment, tact, diplomacy, and ability to problem-solve
  • Able to work effectively in a team environment.
  • Computer literacy is a must.

Schedule (US Shifts Only)

Eastern Time - 6:30 p.m. - 3:30 a.m. IST, Monday - Friday

Pacific Time - 9:30 p.m. - 6:30 a.m. IST, Monday - Friday

Logistical Requirements

Quiet and brightly illuminated work environment

Laptop with Minimum 8GB RAM, I5 8th gen processor

720P Webcam and Headset

A reliable ISP with a minimum speed of 100 Mbps

Smartphone

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