Pre-Authorization

TRIARQ Health is a physician practice services company that partners with doctors to run modern patient-centered practices so they can be rewarded for delivering high-value care. TRIARQs physician-led partnerships simplify practices transition to value-based care by combining our proprietary, cloud-based practice, care management platform, and patient engagement services to help doctors focus on better outcomes.

Industry Type: RCM / US Healthcare

Location: Navi Mumbai (Ghansoli)

Division: Revenue Cycle Management (RCM)

Job Responsibilities

This is a full-time work-from-office role for a pre-authorization specialist. The pre-authorization specialist will be responsible for verifying patient insurance coverage and obtaining pre-authorization for medical procedures prior to services being rendered utilizing online websites, tools, or via phone calls. The pre-authorization specialist will communicate with insurance companies and healthcare providers to resolve any issues or discrepancies in claims.

The pre-authorization specialist needs to be able to review and understand provider medical records. The pre-authorization specialist needs to be able to submit appeals for denied claims and ensure all accurate and pertinent information is provided to the payer in a timely manner.

Skills Required

• The candidate must have at least one year of experience working in the Pre-Auth department.
• The candidate must possess experience in medical billing, as well as in the verification and authorization processes of insurance.
• The candidate must possess strong communication and interpersonal skills to effectively interact with insurance companies.
• Attention to detail and ability to accurately process and manage data.
• Ability to work in a fast-paced environment and meet deadlines.
• Good understanding of medical terminology.
• Good understanding of Payer guidelines.

Employment Type: Full Time, Permanent. Night shift.