Hiring - Prior Authorization Caller- US Healthcare | CHN - Experienced

3 days ago

Chennai, Tamil Nadu, India Oncospark Full time ₹ 3,00,000 - ₹ 6,00,000 per year

Eligibility Verification:

  • Contact insurance companies via calls or portals to verify patient insurance coverage, benefits, co-pays, deductibles, and plan details.
  • Ensure real-time and accurate entry of eligibility details in the system.
  • Identify discrepancies and escalate coverage issues appropriately.

Prior Authorization:

  • Initiate and follow up on prior authorizations required by payers for procedures, medications, or services.
  • Interact with insurance carriers to obtain approvals or resolve denials.
  • Maintain documentation of communication and authorization details in the EMR/RCM systems.

General Duties:

  • Collaborate with providers, clinical teams, and billing departments to ensure authorization compliance.
  • Maintain compliance with HIPAA regulations and company policies.

Preferred candidate profile

  • Knowledge of US healthcare insurance (Medicare, Medicaid, Commercial plans).
  • Strong understanding of CPT, ICD, and HCPCS codes (preferred).
  • Familiarity with EMR/RCM systems and insurance portals.
  • Excellent communication and interpersonal skills.
  • Ability to handle high call volumes and multi-task effectively.

Share your profile to | Contact : Sangeeth.

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