Authorization Specialist

5 days ago


Mumbai, Maharashtra, India Bizmatics India Private Limited Full time
Job Title: Authorization Specialist - Medical Insurance

About the Role:

We are seeking an experienced Authorization Specialist to join our team at Bizmatics India Private Limited. As an Authorization Specialist, you will play a critical role in verifying insurance eligibility and benefit levels to ensure timely authorization of medical services.

Responsibilities:

  • Verify insurance eligibility and benefit levels for patients prior to service receipt.
  • Communicate with payers via electronic, telephonic, and/or fax communications to obtain necessary authorizations.
  • Investigate and resolve pre-certification, authorization, and referral requirements for services.
  • Coordinate with clinical contacts to escalate complex cases requiring peer-to-peer review.
  • Collaborate with clinical partners, financial counselors, and other stakeholders to facilitate the authorization process.
  • Prioritize workload to ensure urgent cases are handled in a timely manner.
  • Complete accurate documentation in the Auth/Cert and Referral Shells.
  • Ensure timely and accurate insurance authorizations are in place prior to services being rendered.

Requirements:

  • Demonstrate knowledge of medical terminology and HIPAA regulations.
  • High proficiency in general medical office procedures.
  • Excellent communication and organizational skills.
  • Ability to work independently and as part of a team.

Compensation:

The estimated annual salary for this position is ₹800,000 - ₹1,200,000 (depending on location) with additional benefits including health insurance, retirement plan, and paid time off.



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