Pre-auth Executive
6 months ago
Verifies insurance eligibility and benefit levels to ensure adequate coverage for identified services prior to receipt, pt estimation calculation
- Successfully works with payers via electronic/telephonic and/or fax communications.
- Responsible for verification and investigation of pre-certification, authorization, and referral requirements for services.
- Coordinates and supplies information to the review organization (payer) including medical information and/or letter of medical necessity for determination of benefits.
- Collaborates with designated clinical contacts regarding encounters that require escalation to peer-to-peer review.
- Communicates with clinical partners, financial counselors(Pt estimation), and others as necessary to facilitate authorization process.
- Facilitates submission of clean claims and reduction in payer denials by adhering to both organizational and departmental policies and procedures and maintaining departmental productivity and quality goals.
- Appropriately prioritizes workload to ensure the most urgent cases are handled in a timely manner. Completes accurate documentation in both the Auth/Cert and Referral Shells.
- Completes notification to all payers via electronic/fax/telephonic means within 24 business hours of service to ensure compliance with Managed Care contractual requirements.
- Ensures timely and accurate insurance authorizations are in place prior to services being rendered.
- Follows departmental policies and procedures when necessary authorization is not obtained prior to service date.
- Communicate any insurance changes or trends among team.
- Clearly document all communications and contacts with providers and personnel in standardized documentation requirements, including proper format.
- Denial management, finding trends/Medical policies benefical for pre-auth process/Identify and report trends and prior authorization issues relating to billing and reimbursement.
- Performs other related duties as required or assigned.
-
Pre-Auth Executive
7 months ago
Mumbai, India Bizmatics India Private Limited Full time-Verifies insurance eligibility and benefit levels to ensure adequate coverage for identified services prior to receipt, pt estimation calculation -Successfully works with payers via electronic/telephonic and/or fax communications. -Responsible for verification and investigation of pre-certification, authorization, and referral requirements for services....
-
Mjpjay Executive
6 months ago
Mumbai, Maharashtra, India Matoshree Indirabai Baburao Sarnaik Hospital Full time**Education Qualification**: Any Graduate, MJPJAY Experience Mandatory **Salary**: - 12,000/- to 15,000/ - **Experience**: 2 yr to 3 yr on this same field **Job Type**: - Full Time, Rotational Shift **Job Timing**: - 10 hours - Having knowledge of MJPJAY and PMJAY Scheme - Experience of working as a pre-auth executive - Knowledge of MJPJAY and PMJAY...
-
Pre- Auth Executive
6 months ago
Navi Mumbai, Maharashtra, India Acme Services Full timeAlso below is the Job Description for the role**:Key Responsibilities**: - Obtains and reviews patient insurance information and eligibility verification to obtain prior-authorizations for injections, DME, Procedures, and surgeries. - Obtains prior-authorizations and referrals from insurance companies prior to procedures or Surgeries utilizing online...
-
Pre-sales Executive
1 month ago
Andheri, Mumbai, Maharashtra, India Boston Institute of Analytics Global Education Pvt Ltd Full time**Job Title: Pre-Sales Executive - EdTech** **Location**: Mumbai **Salary**: ₹4-5 LPA + Performance Incentives **Experience**: Minimum 1 Year in Pre-Sales, Sales, or Telecalling **Industry**: EdTech / Education / Training **About Us**: We are a leading EdTech organization committed to empowering learners with world-class courses designed to help them...
-
Ipd Billing Executive
3 months ago
Ulwe, Navi Mumbai, Maharashtra, India Bone and Joint Care Multispeciality Hospital Full timeDesignation - IPD Billing executive Experience - Freshers also welcome Qualifications - 12th Job roll - Patient admission - preparing patient ipd bill - Co-ordination with Dr consultant & nursing & medico team. - Preparing data base - handling mediclaim pre auth & final approval **Job Types**: Full-time, Permanent, Fresher Pay: ₹10,000.00 -...
-
Customer Relationship Executive- Mumbai
7 months ago
Andheri, Mumbai, Maharashtra, India MEDI ASSIST INSURANCE TPA PRIVATE LIMITED Full time**Client Servicing** - Resolving customer queries within TAT and ensuring smooth claim process - Providing information to the customers and to respond to their claim related queries - Coordinating with the customers/agents for cashless claim settlement - Coordinating with internal stakeholders like enrolment, - Account management, claims, investigation,...
-
Pre-sales Executive
3 months ago
Mumbai, Maharashtra, India Gminfotech Full time**Job Title: Pre-sales Executive** **Job Location: Vasai** **Reports to: Sales Manager/Director - Presales** *** **Job Summary**: As a Presales Executive, you will play a pivotal role in driving sales growth, revenue, and customer satisfaction. Your primary responsibility will be to effectively showcase our properties, understand client needs, and...
-
Tpa Executive
3 months ago
Mumbai, Maharashtra, India Holy Family Hospital, Bandra Full time**Job description** **Responsibilities**: - Handling TPA related all process from billing to co-ordinate with TPA companies. - Responsible for counseling patient's family & pre-Auth process. - Maintaining & uploading patient's files on the portal. - Couriering the hard copy of patient's medical file to the Insurance companies. - Responsible for all...
-
Tpa Executive
7 months ago
Ulwe, Navi Mumbai, Maharashtra, India millennium hospital ulwe Full timeHandling TPA related all process from billing to co-ordinate with TPA companies. - Responsible for counseling patient's family & pre-Auth process. - Maintaining & uploading patient's files on the portal. - Handling billing Department, Implants bill updating & reconciliation. - Daily co-ordination with the patient and Hospital staff. - Preparing split bills/...
-
Pre Sales Executive
2 months ago
Mumbai, Maharashtra, India Triedge Solutions Full timePosition : Pre Sales Executive **JOB ROLE**: - **Graduates to apply**: - **Good communication and sales knowledge required.**: - **Internship experience in sales for 6 months minimum required.**: - **Fluent English required.** **Job Types**: Full-time, Fresher Pay: ₹25,000.00 per month **Benefits**: - Health insurance Compensation Package: -...
-
Pre-press Executive Offset Ctp Pre-press.- Navi
6 months ago
Navi Mumbai, Maharashtra, India Kaushal Placement Services Full timeUrgent opening Pre-press Executive Offset CTP pre-press. Navi Mumbai Position: Pre-press Executive CTC : 3 to 3.8 Lacs 2-3 year experience, experience of Offset CTP pre-press. Technical Qualification: Diploma in Printing Technology Imm. joining Adobe Skill: Illustrator JOB Description: Prepare step & repeat layout for Offset & digital...
-
Pre-sales E-commerce Sales Executive
3 months ago
Andheri, Mumbai, Maharashtra, India 99yrs Network LLP Full timeAbout Us: 99yrs Network is a leading global e-commerce services provider, offering innovative solutions to online retailers and brands. Our mission is to empower businesses to succeed in the digital landscape. We value teamwork, innovation, and customer satisfaction. Job Summary: As a Pre-sales E-commerce Sales Executive, you will identify and pursue new...
-
Pre-sales Executive
6 months ago
Mumbai, Maharashtra, India ATRINA Full time**_Build something new with a world-class team._** At Atrina, we allow our employees to make their mark by entrusting them to make decisions and do what they’ve been hired to do: their very best. Your potential is waiting; why are you? **Company**: Atrina Technologies Pvt Ltd **Location**: Mumbai **Position**:Pre-Sales Executive **Salary**: As per...
-
Pre-sales Executive
4 weeks ago
Mumbai, Maharashtra, India Simplyfyd Solutions Full time**Profile: Pre Sales Executive** **Location : Panvel** 1. should have good communication skill, tele calling experience of at least 1 year. 2. Should work on TARGETS allotted by the Team leader. 3. Should be well averse with excel. 4. Must have experience in_**real estate.**_ 5. Marathi and Hindi Compulsory **Job Types**: Full-time, Permanent Pay:...
-
Pre-sales Executive
6 months ago
Navi Mumbai, Maharashtra, India Geekout Cooperation LLP Full time**Job Designation**:Pre-sales Executive **Location**:Turbhe, Navi Mumbai **Experience**:6 months **Salary**:15k - 25k **Responsibilities**: - Handling customer questions, inquiries, and complaints. - Preparing and sending quotes and proposals. - Managing the sales process through specific software programs. - Maintaining a CRM database. - Meeting daily,...
-
Pre-sales Executive
6 months ago
Mumbai, Maharashtra, India AR TECHNOLOGY Full time**Pre-Sales Executive** Experience - **1 to 3 Years** **Excellent Communication Skills.** Prior Experience in **Real Estate Preferred.** 6 Days Working - **Tuesday to Sunday.** Job Location - **Vikhroli West, Mumbai** Key responsibilities: - Curate prospective buyers and move customers through the sales funnel and cycle. - Nurture potential prospects...
-
Pre Sales Executive
6 months ago
Bandra East, Mumbai, Maharashtra, India Kochra Realty . Full time**Role Description - Pre Sales Executive** **Kochra Realty** is looking for **Pre Sales Executive ** full-time who can Join us in our Mumbai office to add value to our business and enhance our customer service through their skills and experience. Tele callers are responsible for making outbound and inbound calls to the company's customers to follow up on...
-
Pre- Sales Executive
1 month ago
Kanjurmarg, Mumbai, Maharashtra, India IT Aakash Strategic Software Pvt Ltd Full timeJob Role: Pre-Sales Executive Company: IT Aakash Strategic ERP Location: Mumbai (Kanjurmarg) Experience: 6 Months/ 1+ Years **Salary**: Open to Discuss Work Mode: Work From office **PERKS AND BENEFITS**: **SALARY + Attractive Incentive Plans, Performance Pay, Bonus schemes** **Company Details**:Strategic ERP IT solutions are developed to provide...
-
Pre-sales Executive
6 months ago
Pune, Maharashtra, India Unique Properties Full timeUnique Properties is seeking a highly motivated and experienced **Pre-Sales Executive** with experience in **Real Estate Developer Organization** to join our team. As a Pre-Sales Executive, you will play a pivotal role in driving sales growth by effectively engaging with prospective clients and assisting them in their property buying decisions. You will act...
-
Pre-sales Executive
6 months ago
Pune, Maharashtra, India SVB REALTY Full timeCome with your resume between 10 AM to 6 PM. To schedule your interview, call us on (020)-6687-7030 **Job Title: Pre-Sales Executive - 5 position **Experience**: 2-3 Years Pre-sales **Location**: Pune **Education**: Minimum Any Graduation Handling calls, follow-ups, planning site visits, co-ordination with Sales Team. **Requirement**: Fluent in English