Job Description

Handle prior authorization requests for medical procedures, diagnostic tests, surgeries, and prescription medications. Liaise with healthcare providers and insurance companies to collect required information. Review patient records and billing data to determine prior authorization requirements. Maintain accurate documentation by updating patient records and billing systems with authorization details. Monitor authorization requests , follow up on approvals or denials, and resolve issues, appeals, and discrepancies efficiently. Ensure compliance with insurance guidelines, policies, and industry regulations while meeting productivity and quality targets . Preferred Candidate Profile: 5 to 8 years of experience in RCM with expertise in Prior Authorization . Strong communication and customer service skills .