Authorization Executive

Job Purpose

We are seeking a detail-oriented Authorization Executive with experience in cardiology and therapy service authorizations to join our medical billing team. This role ensures timely and accurate processing of prior authorizations, supporting seamless patient care and smooth revenue cycle management.

Key Responsibilities

• Obtain prior authorizations for cardiology procedures, diagnostic tests, and therapy services.
• Review medical documentation to ensure compliance with payer requirements.
• Verify insurance eligibility and benefits before initiating authorization requests.
• Submit and track authorization requests through payer portals and maintain accurate records.
• Follow up with insurance companies to secure timely approvals and resolve denials.
• Collaborate with physicians, clinical staff, and billing teams to ensure smooth workflow.
• Maintain up-to-date knowledge of payer policies, medical necessity guidelines, and regulatory requirements.

Requirements

• Proven experience in authorization processes, specifically in cardiology and therapy services.
• Knowledge of U.S. healthcare insurance systems, payer portals, and pre-certification workflows.
• Strong communication and follow-up skills with payers and clinical staff.
• Attention to detail, organizational skills, and ability to work under tight deadlines.
• Proficiency in medical billing/EMR software preferred.
• Minimum education: High school diploma or equivalent (Bachelor’s or certification in Medical Billing is a plus).

Performance Expectations

• Meet turnaround times for all authorization requests.
• Maintain a high accuracy rate in submissions and documentation.
• Reduce authorization-related denials through proactive follow-up and compliance.

Job Type: Full-time

Pay: Rs30,000.00 - Rs60,000.00 per month

Work Location: In person