SR Prior Authorization

Greeting from Sutherland,

We are currently hiring Experienced PRIOR AUTHORIZATION for our Hyderabad locations (Uppal ). If you are looking for a new opportunity or know someone who would be a great fit, please share this opening within your network.

Job Title: Prior Authorization Specialist
Department: Healthcare Operations / Medical Billing
Experience: 2 TO 4 years (preferred)
Location: Hyderabad - Uppal
Employment Type: Full-time

Job Summary

We are looking for a detail-oriented Prior Authorization Specialist to manage the authorization process for medical services, procedures, medications, and treatments. The role involves verifying insurance requirements, submitting authorization requests, following up with payers, and ensuring timely approvals to avoid delays in patient care.

Key Responsibilities

• Verify patient insurance eligibility and benefits.
• Determine whether prior authorization is required for specific services or procedures.
• Prepare and submit prior authorization requests to insurance companies.
• Collect and review required clinical documentation, medical records, and supporting information.
• Communicate with insurance companies, providers, and clinical teams regarding authorization status.
• Track pending, approved, denied, and expired authorizations.
• Follow up with payers to obtain authorization decisions within required timelines.
• Identify authorization denials and assist with appeals or reconsideration requests.
• Maintain accurate documentation in the appropriate systems.
• Ensure compliance with payer guidelines, HIPAA/privacy requirements, and organizational policies.
• Meet productivity, accuracy, turnaround-time, and quality targets.

Required Skills

• Knowledge of US healthcare insurance and prior authorization processes.
• Understanding of medical terminology and basic clinical documentation.
• Familiarity with insurance payers, CPT/HCPCS codes, ICD-10 codes, and medical necessity.
• Strong written and verbal communication skills.
• Good analytical and problem-solving abilities.
• Excellent attention to detail and organizational skills.
• Ability to work with EMR/EHR, payer portals, and authorization platforms.
• Proficiency in MS Office, particularly Excel and Outlook.

Perks & Benefits:

Night Shift Allowance 100 per working day

Fixed Week Offs Saturday & Sunday

Two-way Cab Facility (within a 25 km radius)

Self-Transportation Allowance up to 3,500

If you are interested or have suitable referrals, please share your updated resume or contact me for more details pranavi - 6301461823

Note: "Sutherland never requests payment or favors in exchange for job opportunities. Please report suspicious activity immediately to [email protected]