Hiring -Clinical Prior Authorization Executive & QA roles in Hyderabad
2 days ago
We're Hiring | Clinical Prior Authorization Executive & QA
Open Roles:
- Clinical Prior Authorization Executive
- Quality Analyst (QA) Prior Authorization
Job Responsibilities:
For Clinical Prior Authorization Executive:
- Review medical records and prior authorization requests.
- Validate clinical necessity based on payer policies and guidelines.
- Coordinate with healthcare providers and insurance companies.
- Accurately document and process approvals/denials in the system.
For QA Role:
- Audit completed prior authorization cases.
- Ensure compliance with quality standards and turnaround times (TAT).
- Provide feedback and support to improve team performance.
- Maintain documentation and generate quality reports.
Requirements:
- Bachelor's degree in Life Sciences, Pharmacy, Nursing, or equivalent.
- Dimploma are not eligible or
- Prior experience in US Healthcare or RCM (Revenue Cycle Management) preferred.
- Strong communication skills (written & verbal).
- Detail-oriented with strong analytical thinking.
Interested candidates can share your updated resume to
HR Sumalika share resume via WhatsApp)
Refer your friend's / Colleagues'
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