PRE Authorisation Specialist

6 days ago

Gurgaon, Haryana, India Nextdim Tech Services Full time ₹ 5,00,000 - ₹ 8,00,000 per year

Prior Authorization Specialist (Procedures)

About Us

At NextDimension AI, our mission is to simplify healthcare. We are a technology company building the next generation of AI-powered systems to automate complex workflows and create a more responsive, patient-centric experience. We have bold ambitions to reimagine healthcare, setting a new standard for how care is delivered and experienced across the industry. Our growing suite of AI solutions spans the Front Office, Clinical Operations, and Revenue Cycle Management.

Website:

Healthcare's moment for AI-powered transformation is here, and we're building the technology to power it. Come join us in shaping the future of healthcare.

Role Description

As a Prior Authorization Specialist for Procedures, you will be a crucial link between our patients, our clinical team, and insurance carriers. Your primary responsibility will be to secure financial clearance for all office-based and hospital-based gastroenterology procedures, such as endoscopies, colonoscopies, and capsule endoscopies. You will manage a high volume of authorization requests, meticulously track their status, and ensure all necessary approvals are in place before the patient's scheduled service.

Key Responsibilities:

  • Verify patient insurance eligibility and benefits for all scheduled GI procedures.
  • Initiate, submit, and diligently follow up on prior authorization requests through insurance portals, phone, and fax.
  • Gather and attach required clinical documentation (physician notes, lab results, imaging reports) to justify medical necessity.
  • Communicate effectively with physicians, nurses, and scheduling staff regarding the status of authorizations.
  • Document all activities and outcomes accurately in the patient's electronic health record (EHR).
  • Address and resolve initial authorization rejections or requests for additional information.

Qualifications:

  • Minimum of 2 years of experience in medical prior authorizations, specifically for surgical or medical procedures.
  • Strong understanding of CPT (procedural) and ICD-10 (diagnostic) codes is required.
  • Demonstrated experience navigating the portals of major medical insurance carriers (e.g., UnitedHealthcare, Aetna, Cigna, BCBS).
  • Ability to read and interpret clinical documentation to extract information supporting medical necessity.
  • Excellent organizational skills and the ability to manage a large caseload with competing deadlines.
  • Experience in gastroenterology or surgical practice is highly preferred.

Compensation:

Base Salary: INR 5-8 LPA

Bonus: Upto 10% based on performance.

  • Pre-Sales Specialist – Switching and Routing

    2 weeks ago

    Gurgaon, Haryana, India HFCL Limited Full time ₹ 15,00,000 - ₹ 20,00,000 per year

    Job Description: Pre-Sales Specialist – Switching and RoutingPosition Title:Pre-SalesSpecialist – Switching and RoutingLevel/Designation:ManagerDepartment:Pre-SalesBusiness Unit:Telecom BUReporting to:Pre-Sales HeadWork Location:GurgaonFull TimeÖFTE ContractualJob Purpose:To provide expert-level technical pre-sales support for IP/MPLS routing and Layer...

  • International Pre-Sales Specialist – Wi-Fi

    2 weeks ago

    Gurgaon, Haryana, India HFCL Limited Full time ₹ 15,00,000 - ₹ 20,00,000 per year

    Job Description: International Pre-Sales Specialist – Wi-FiPosition Title:InternationalPre-SalesSpecialist – Wi-FiLevel/Designation:ManagerDepartment:Pre-SalesBusiness Unit:Telecom BUReporting to:Pre-Sales HeadWork Location:GurgaonFull TimeJob Purpose:To support the global sales team by providing deep technical expertise in Wi-Fi and switching solutions,...

  • Marketing Specialist

    2 weeks ago

    Gurgaon, Haryana, India Shiv Shakti Oil & Lubricants Full time US$ 6,00,000 - US$ 12,00,000 per year

    Company DescriptionShiv Shakti Oil & Lubricants (SSOL) India offers end-to-end hazardous waste management solutions across India. The company operates a government-authorized TSDF and holds a pre-processing license for legally collecting and handling hazardous waste from industries nationwide. SSOL's services include hazardous waste collection &...

  • Marketing Operations Specialist

    2 weeks ago

    Gurgaon, Haryana, India beBeeMarketing Full time ₹ 90,00,000 - ₹ 1,20,00,000

    About the Role">You will be part of our Health Sciences India team, working as a Marketing Operations and Pre-Media Specialist. Your role is crucial to the daily operations of the marketing team and supporting all business promotional needs for the marketing function.

  • Residential Sales Manager

    2 weeks ago

    Gurgaon, Haryana, India Reallysafe (Real estate job consultancy) Full time ₹ 15,00,000 - ₹ 20,00,000 per year

    Position Overview:Person shall be responsible for direct or indirect sales, new channel business development, related MIS etc.Key ResponsibilitesDirect Sales: Explore new potential customers in the allocated area/region by visiting their offices/homes and inviting them to sales gallery for product presentation.New CP Development: Identify and connect with...

  • Content Specialist

    1 week ago

    Gurgaon, Haryana, India Naukripay group Full time US$ 60,000 - US$ 1,20,000 per year

    Company DescriptionNaukripay was founded in 2021 with the objective of reimagining careers by simplifying job information and ending mis-guidance. We provide customized manpower services tailored to the needs of various industries, ranging from turn-key project implementation to ongoing workforce management. Our experienced team ensures high productivity and...

  • Chief Recruitment Specialist

    2 weeks ago

    Gurgaon, Haryana, India beBeeSourcing Full time ₹ 10,00,000 - ₹ 15,00,000

    Key Role ResponsibilitiesJob Overview:We are seeking a skilled Talent Acquisition specialist to assume key recruitment responsibilities at our organization. The successful candidate will be responsible for identifying, sourcing and recruiting top talent for IT roles, with a strong focus on verbal and written communication skills, technical expertise and...

  • Principal Quality Operations Specialist

    2 weeks ago

    Gurgaon, Haryana, India McDermott International, Ltd Full time ₹ 9,00,000 - ₹ 12,00,000 per year

    Job DescriptionJob Overview:The Principal Quality Operations Specialist interprets internal and external business challenges in the operations discipline. The role requires specialized depth and breadth of expertise in operations.ResponsibilitiesKey Tasks and Responsibilities:Visiting and Perform inspection at supplier's premises/site, to determine product...

  • Principal Quality Operations Specialist

    2 weeks ago

    Gurgaon, Haryana, India McDermott Full time US$ 90,000 - US$ 1,20,000 per year

    Job Overview:The Principal Quality Operations Specialist interprets internal and external business challenges in the operations discipline. The role requires specialized depth and breadth of expertise in operations.Lutech Resources has over 25 years' experience providing tailor made recruitment and integrated resource management to leading Engineering,...

  • Fresher | business specialist interns

    5 days ago

    Gurgaon, Haryana, India Delta Velocity Full time

    ???? Business Specialist Internship (Freshers – PPO Offer) at Delta VelocityCompany Description Delta Velocity unifies AI intelligence with human expertise to transform logistics, making it smarter, faster, and transparent. We leverage advanced technology and practical know-how to enhance efficiency, precision, and trust across every movement in the supply...