Prior Authorization Specialist

1 day ago


India beBeeInsurance Full time ₹ 40,00,000 - ₹ 80,00,000
Medical Insurance Verification and Prior Authorization Expert

Crammaze is seeking a reliable, organized and experienced Medical Insurance Verification & Prior Authorization Specialist to join our fast-paced team. This role plays a vital part in supporting our sleep studies and DME services.

Key Responsibilities:
  • Verify patient insurance benefits and eligibility for medical procedures including sleep studies and DME.
  • Efficiently obtain prior authorizations from various insurance plans.
  • Explain co-pays, deductibles and co-insurance to patients with clear and professional communication.
  • Work closely with HMO and PPO insurance plans.
  • Document and track authorizations within EMR systems and Excel spreadsheets.
  • Collaborate effectively with the front office and billing teams when needed.
  • Manage high call volumes while maintaining excellent phone etiquette and attention to detail.
Requirements:
  • Minimum 2 years of experience in medical insurance verification and prior authorization.
  • Strong understanding of co-pays, deductibles, co-insurance and insurance plan types.
  • Knowledge of sleep studies and DME services is preferred but not essential.
  • Ability to multitask and prioritize tasks efficiently.
  • Excellent verbal and written communication skills are necessary.
  • Proficiency in EMR systems and Microsoft Office, particularly Excel, is required.
  • A strong team player with a positive attitude is essential for this role.

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