Prior Authorization Analyst

7 days ago

bangalore, India Nath Outsourcing Solutions Pvt. Ltd. Full time

Job Title: Prior Authorization Analyst Location: WFO – Mohali Department: RCM | US Healthcare Experience: 1–3 Years Shift: US Shift Role Summary We are hiring a Prior Authorization Analyst (US Healthcare) responsible for obtaining timely medical authorizations from insurance carriers, reviewing clinical documents, and ensuring approvals to reduce denials and secure accurate reimbursement. Key Responsibilities Review patient clinical documents and verify insurance guidelines. Initiate and obtain prior authorizations via calls, payer portals, and fax. Follow up with insurance providers for pending approvals. Coordinate outcomes with providers, billing, and scheduling teams. Maintain accurate documentation in EMR/EHR systems. Required Skills Minimum 1 year experience in Prior Authorization / Pre-cert / UM . Strong knowledge of CPT, HCPCS, ICD-10 & payer rules. Experience with payer portals & EMR (eCW, EPIC, Athena, etc.). Good communication & coordination skills. Work Mode Work From Office (WFO) – Mohali

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