Hiring Prior Authorization Specialists For MNC(Hyderabad)

Prior Authorization Specialist

Job Description

Job Summary:

We are seeking experienced and detail-oriented Prior Authorization

Specialists with a strong understanding of medical terminology and

healthcare insurance processes. The ideal candidate will be responsible for

obtaining prior authorizations and referrals from insurance companies,

verifying patient insurance eligibility, and coordinating with payers to ensure

timely approvals for procedures, surgeries, injections, and DME services.

Key Responsibilities:

• Obtain prior authorizations and referrals from insurance companies

through payer portals and telephonic communication.

• Verify patient insurance coverage, benefits, and eligibility

requirements.

• Review and process authorization requests for procedures, surgeries,

injections, and Durable Medical Equipment (DME).

• Provide insurance companies with the necessary clinical

documentation to secure approvals.

• Track, monitor, and update authorization statuses, orders, and tasks in

the system.

• Follow up with insurance providers on pending authorization requests.

• Maintain accurate records and ensure compliance with payer

guidelines and organizational standards.

• Collaborate with physicians, clinical staff, and insurance

representatives to resolve authorization-related issues.

• Ensure timely completion of authorization requests to avoid delays in

patient care.

Required Skills & Qualifications:

• Minimum 1.6+ years of experience in Prior Authorization / Pre-

Authorization.

• Strong knowledge of medical terminology and healthcare insurance

processes.

• Experience working with insurance portals and payer guidelines.

• Excellent communication and follow-up skills.

• Strong attention to detail and documentation accuracy.

• Ability to work in a fast-paced healthcare environment.

• Familiarity with EMR/EHR systems is preferred.

Preferred Candidate Profile:

• Experience handling authorizations for surgeries, procedures,

injections, and DME.

• Good analytical and problem-solving skills.

• Should be a Graduate.

• Ability to manage multiple tasks with minimal supervision.

Benefits:

Night Shift Allowance: 100 per working day

Fixed Week Offs: Saturday & Sunday

Two-Way Cab Facility (Within 25 KM Radius)

Self-Transportation Allowance up to 3,500 per month

Excellent Career Growth Opportunities