Qureos Mentor

Next Dimension

About UsAt NextDimension AI, our mission is to simplify healthcare. We are a technology company building the next generation of AI-powered systems to automate complex workflows and create a more responsive, patient-centric experience. We have bold ambitions to reimagine healthcare, setting a new standard for how care is delivered and experienced across the industry. Our growing suite of AI solutions spans the Front Office, Clinical Operations, and Revenue Cycle Management.Website: nextdim.ioHealthcare's moment for AI-powered transformation is here, and we're building the technology to power it. Come join us in shaping the future of healthcare.Role DescriptionAs a Prior Authorization Specialist for Procedures, you will be a crucial link between our patients, our clinical team, and insurance carriers. Your primary responsibility will be to secure financial clearance for all office-based and hospital-based gastroenterology procedures, such as endoscopies, colonoscopies, and capsule endoscopies. You will manage a high volume of authorization requests, meticulously track their status, and ensure all necessary approvals are in place before the patient's scheduled service.Key Responsibilities:<ul><li>Verify patient insurance eligibility and benefits for all scheduled GI procedures.</li><li>Initiate, submit, and diligently follow up on prior authorization requests through insurance portals, phone, and fax.</li><li>Gather and attach required clinical documentation (physician notes, lab results, imaging reports) to justify medical necessity.</li><li>Communicate effectively with physicians, nurses, and scheduling staff regarding the status of authorizations.</li><li>Document all activities and outcomes accurately in the patient's electronic health record (EHR).</li><li>Address and resolve initial authorization rejections or requests for additional information.</li></ul>Qualifications:<ul><li>Minimum of 2 years of experience in medical prior authorizations, specifically for surgical or medical procedures.</li><li>Strong understanding of CPT (procedural) and ICD-10 (diagnostic) codes is required.</li><li>Demonstrated experience navigating the portals of major medical insurance carriers (e.g., UnitedHealthcare, Aetna, Cigna, BCBS).</li><li>Ability to read and interpret clinical documentation to extract information supporting medical necessity.</li><li>Excellent organizational skills and the ability to manage a large caseload with competing deadlines.</li><li>Experience in gastroenterology or surgical practice is highly preferred.</li></ul>Compensation:Base Salary: INR 5-8 LPABonus: Upto 10% based on performance.Job Type: Full-timePay: &#8377;40,000.00 - &#8377;60,000.00 per monthBenefits:<ul><li>Paid time off</li></ul>Application Question(s):<ul><li>Do you have experience with CPT (procedural) and ICD-10 (diagnostic) codes ?</li></ul>Experience:<ul><li>Medical Prior Authorization: 2 years (Required)</li></ul>Location:<ul><li>Gurgaon, Haryana (Required)</li></ul>Shift availability:<ul><li>Night Shift (Required)</li></ul>Work Location: In person

Prior Authorization Specialist (Procedures)

Join Next Dimension 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.

Next Dimension

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Prior Authorization Specialist (Procedures)