Prior Authorization Analyst
4 weeks ago
Prior Authorization Specialist - Immediate Joiners Needed Job Summary The Prior Authorization Specialist is responsible for obtaining, verifying, and documenting prior authorizations from insurance providers for medical services and procedures. This role ensures all required approvals are secured in a timely manner to prevent service delays, claim denials, and revenue loss. The Specialist acts as a liaison between providers, patients, and insurance companies to streamline the authorization process and ensure compliance with payer requirements. Key Responsibilities Authorization Request Management: Initiate and follow up on prior authorization requests for medical services, diagnostic tests, and procedures with insurance companies. Insurance Communication: Coordinate with insurance providers to verify the necessity and coverage of requested services. Clinical Information Gathering: Collect and submit necessary medical documentation (e.g., clinical notes, test results) to support authorization requests. Timely Follow-Up: Track authorization requests to ensure timely approvals and address any denials or pending issues proactively. Documentation & Record-Keeping: Maintain accurate and complete records of all authorization requests, approvals, and denials in accordance with organizational standards. Coordination with Providers: Work closely with physicians, clinical staff, and scheduling teams to obtain required information for submission to payers. Denial Management: Identify reasons for authorization denials and work to resolve issues or submit appeals as needed. Policy & Coverage Verification: Confirm insurance plan requirements for authorizations, including coverage limitations, medical necessity criteria, and pre-certification rules. Payer Portal Utilization: Access and navigate payer portals (Medicare, UHC, BCBS, Availity, Trizetto, etc.) to submit and track prior authorization requests. Compliance: Ensure all authorizations are obtained in compliance with payer regulations and organizational policies. Skills & Qualifications Graduation in any stream. Strong understanding of insurance authorization processes, payer requirements, and medical necessity criteria. Knowledge of payer portals such as Medicare (Noridian), UHC, BCBS, Availity, and Trizetto. Experience with prior authorization workflows in a healthcare environment. Familiarity with insurance plan types (HMO, PPO, EPO, POS) and coverage policies. Excellent organizational and follow-up skills to manage multiple authorization requests simultaneously. Strong communication skills to coordinate between providers, patients, and insurance companies. Attention to detail and ability to interpret insurance policies and medical documentation. Minimum of 2 years of experience in prior authorization (Physician Billing) or related healthcare roles. Interested Candidates please contact us on asood@nath-mds.com / hanand@nath-mds.com / **** Immediate joiners welcomed = Bonus - 10000***
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Prior Authorization
4 days ago
Mohali, Punjab, India 3D Solutions LLC Full timeJob Summary: The Prior Authorization and Eligibility Specialist is responsible for verifying patient insurance coverage, obtaining prior authorizations for medical procedures, and ensuring that services are covered under the patient’s insurance plan. This role plays a critical part in minimizing claim denials and ensuring timely reimbursement. Key...
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Authorization (Medical Billing)
1 week ago
Mohali, Punjab, India PAMM INFOTECH PVT LTD Full time**Job description** **Job Summary**:The Eligibility Verification & Authorization Specialist is responsible for verifying patient insurance coverage, determining eligibility for services, and securing prior authorizations and referrals as required by insurance carriers. This role plays a vital part in ensuring patients receive timely care and that services...
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Mohali, Punjab, India PAMM INFOTECH PVT LTD Full time**Job Summary**:The Eligibility Verification & Authorization Specialist is responsible for verifying patient insurance coverage, determining eligibility for services, and securing prior authorizations and referrals as required by insurance carriers. This role plays a vital part in ensuring patients receive timely care and that services are reimbursed...
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Eligibility Verification
1 week ago
Mohali, Punjab, India PAMM INFOTECH PVT LTD Full time**Job Summary**:The Eligibility Verification & Authorization Specialist is responsible for verifying patient insurance coverage, determining eligibility for services, and securing prior authorizations and referrals as required by insurance carriers. This role plays a vital part in ensuring patients receive timely care and that services are reimbursed...
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Quality Analyst
1 day ago
Mohali, India TP Full timeWe’re Hiring || Quality Analyst || International Process || Location: Mohali Key Responsibilities: ✅ Monitor and evaluate calls to ensure quality standards ✅ Provide feedback and coaching to enhance performance ✅ Identify process gaps and suggest improvements ✅ Ensure compliance with organizational guidelines What We’re Looking For: ✨ Strong...
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AR Analyst
3 weeks ago
Mohali, India Nath Outsourcing Solutions Pvt. Ltd. Full timeJob Description Account Receivable Analyst (AR) About the company: Established in 2003, Nath Outsourcing Solutions Pvt. Ltd. (NOS) specializes in end-to-end solutions for the US Healthcare Industry. Our expertise includes managed care, payer rules, coding, and compliance, all supported by advanced technology and a deep understanding of Revenue Cycle...
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Quality Analyst
1 day ago
Mohali district, India TP Full timeWe’re Hiring || Quality Analyst || International Process || Location: Mohali Key Responsibilities: ✅ Monitor and evaluate calls to ensure quality standards ✅ Provide feedback and coaching to enhance performance ✅ Identify process gaps and suggest improvements ✅ Ensure compliance with organizational guidelines What We’re Looking For: ✨ Strong...
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Quality Analyst
1 day ago
mohali district, India TP Full timeWe’re Hiring || Quality Analyst || International Process || 📍 Location: Mohali🔑 Key Responsibilities:✅ Monitor and evaluate calls to ensure quality standards✅ Provide feedback and coaching to enhance performance✅ Identify process gaps and suggest improvements✅ Ensure compliance with organizational guidelines🎯 What We’re Looking For:✨...
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Quality Analyst
1 day ago
Mohali district, India TP Full timeWe’re Hiring || Quality Analyst || International Process || 📍 Location: Mohali🔑 Key Responsibilities:✅ Monitor and evaluate calls to ensure quality standards✅ Provide feedback and coaching to enhance performance✅ Identify process gaps and suggest improvements✅ Ensure compliance with organizational guidelines🎯 What We’re Looking For:✨...
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Eligibility Verification
1 week ago
Mohali, Punjab, India PAMM INFOTECH PVT LTD Full time ₹ 3,00,000 - ₹ 4,20,000 per yearThe Eligibility Verification & Authorization Specialist is responsible for verifying patient insurance coverage, determining eligibility for services, and securing prior authorizations and referrals as required by insurance carriers. This role plays a vital part in ensuring patients receive timely care and that services are reimbursed accurately by...
