Qureos Mentor

Eclat Health Solutions

<div><div><b>Job Description &ndash; Associate, Inpatient Prior Authorization</b></div><div><b>
Associate &ndash; Inpatient Prior Authorization</b></div><div>
Department: Revenue Cycle Management / Utilization Management</div><div>
Reports To: Team Lead &ndash; Prior Authorization / Prior Authorization Supervisor</div><div>
Job Level: Associate / Entry to Mid-Level</div><div>
Work Location: RMZ, Hi-Tech city Hyderabad</div><div>
Employment Type: Full-time</div><div><b>
Position Summary</b></div><div>
The Associate &ndash; Inpatient Prior Authorization is responsible for verifying insurance coverage, initiating, obtaining, and tracking inpatient authorizations for hospital admissions, continued stays, and post-acute transitions. The associate ensures that all required authorizations are secured before or during a patient&rsquo;s hospital stay, in compliance with payer policies, to prevent claim denials and delays in reimbursement.</div><div><b>
Key Responsibilities</b></div><div>
Review inpatient admissions and identify cases requiring prior authorization based on payer rules and plan benefits.</div><div>
Initiate inpatient authorization requests through payer portals (e.g., Availity, NaviNet, Optum, UHC Link, etc.) or via phone/fax.</div><div>
Submit medical documentation (H&amp;P, clinical notes, diagnostic reports) to support medical necessity review.</div><div>
Obtain initial admission approvals and ensure concurrent/continued stay authorizations are updated before expiration.</div><div>
Verify authorization details (auth number, date span, approved services) and record accurately in EMR (EPIC, Cerner, Meditech, etc.).</div><div>
Communicate with payer representatives to follow up on pending authorization requests.</div><div>
Coordinate with Utilization Review Nurses and Case Managers to gather clinical updates for concurrent reviews.</div><div>
Maintain logs for pending, approved, denied, and appealed authorization requests.</div><div>
Assist the denials management team by providing authorization information for appeals.</div></div><div></div>

Pre-Auth Associates - 10th Oct'25

Join Eclat Health Solutions and explore 1   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Eclat Health Solutions

ABOUT_COMPANY

Pre-Auth Associates - 10th Oct'25