Walk-in || Prior Authorization Executive

Job highlights

• 1-5 years experience in Authorization/Pre-Authorization with strong knowledge of CPT, ICD, HCPCS codes and medical terminology
• Handle prior authorization requests, submit accurate patient and clinical info, follow up on request statuses, coordinate for medical records, and maintain compliance

Role & responsibilities

Handle prior authorization and pre-authorization requests for US healthcare services.

• Submit authorization requests with accurate patient and clinical information.
• Follow up on pending, approved, denied, and additional-information requests.
• Review and understand CPT, ICD, HCPCS codes, medical terminology, and payer guidelines.
• Coordinate with internal teams to obtain required medical records and supporting documentation.
• Maintain accurate authorization details and update the system within the required timelines.
• Maintain quality, productivity, and compliance with company and client requirements.

Preferred candidate profile

0-5 Prior experience in Authorization / Pre-Authorization is preferred.

Strong attention to detail and ability to maintain accurate documentation.

Ability to work independently as well as in a team.

Good analytical and problem-solving skills.

Willingness to work in US/night shifts.

Strong understanding of medical terminology, CPT, ICD, and HCPCS codes.