POSITION
RCM Executive
Job responsibilities include:
l Initiate pre-authorization request with payer via Call/web-Portal/Fax.
l Follow-up on raised pre-auth request based on time frame set by management / client.
l Maintain dynamic Authorization trackers on client applications and internal trackers.
l Calling insurance for any update on pending / rejected authorization request to ensure max approval on raised pre-auth requests.
l Responding back to client with approved pre-authorization letters which we receive via portals/emails/fax. (applicable sources).
l Uploading Approved letters to client applications or reliable sources on timely manner.
JOB DESCRIPTION
l Primary task is to initiate Pre-authorization request on timely manner.
l This process involves calling/using web Portals and faxing.
l Must be efficient in managing Turn around Time (TAT) set by management / client.
l Agent must be willing to learn new things related to process.
l Must be a team player and must share process updates with his/her immediate reporting supervisor.
l Take up ownership on every single Pre-auth request assigned until request approved / escalated to client if case of request rejected or held.
l Achieve his/her set targets with highest level of quality.
JOB REQUIREMENTS
l Any Degree with minimum of 2-3 years of experience in US Healthcare.
l Good communication skills and must have min 1 years of calling experience.
l Should have worked at least 6 months for pre-authorization process.
l Strong knowledge in Authorization process and requirements.
l Should be willing to work in night shift without cab.
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