Specialist, Insurance Authorization

This job description is for a Specialist in Insurance Authorization based in Hyderabad. Its a core role in the healthcare revenue cycle, focusing on securing approvals from insurance providers before medical services are rendered.

Here is a simplified version of the job description and a list of the mandatory skills you can share with candidates.

Job Summary: Specialist, Insurance Authorization

Location: Hyderabad, Telangana (Divyasree Techridge) Experience: 1 – 3 Years Education: Bachelor’s Degree (Any stream)

What You Will Do

• Secure Approvals: Coordinate between doctors' offices and insurance companies to get "prior authorization" for medical procedures.
• Review Records: Identify and submit the correct clinical documents/medical records required by insurance plans to approve payments.
• Act as a Liaison: Commuicate with healthcare providers to ensure all necessary documentation is gathered to avoid payment denials.
• Maintain Quality: Achieve high accuracy (95%+) in handling accounts and meeting productivity standards.

Mandatory Skills & Requirements To be considered for this role, candidates must have:

• Healthcare Experience: 1 to 3 years of experience in a healthcare-related role.
• Insurance Knowledge: A strong understanding of the Patient Access process, managed care, and insurance verification.
• Revenue Cycle Awareness: Familiarity with the end-to-end Revenue Cycle (Admissions, Billing, Payments, and Denials).
• Medical Literacy: Knowledge of medical terminology, CPT codes, or procedure codes.
• Technical Proficiency: Skilled in MS Office (Excel, Word, and PowerPoint) for data entry and reporting.
• Communication: Excellent verbal and written English communication skills to interact with insurance adjusters and medical staff.

Preferred (Bonus) Skills

• CRCR Certification: Being a Certified Revenue Cycle Representative is a significant advantage.
• Analytical Thinking: Ability to spot discrepancies in insurance plans and medical records quickly.
• 1 to 3 y Exp
• Night shift