Check the patient's insurance eligibility and benefits for medical services.
Contact payers to determine network status of practice and provider.
Prepare and submit prior authorization (PA) requests to insurance companies.
Communicate with practice to obtain supporting reports or clinical notes.
Convey prior authorization status updates to the practice.
Ensure that all required documentation and clinical information is included.
Follow up with the payer on the status of the pending authorization requests.
Obtain the authorization determination information from the payer.
Resolve denials or incomplete submissions by gathering additional documentation or initiating authorization appeals.
Accurately log all submitted and received authorizations in the electronic health record (EHR) or in the client tracking system.
Follow up and maintain update of payer-specific policies / guidelines and prior authorization requirements.
Help monitor prior authorization request turnaround times to ensure deadlines are met.
Adhere to HIPAA regulations and internal policies to ensure patient's privacy.
Ensure all authorization requests are compliant with payer guidelines and healthcare regulations.
Participate in staff training in prior authorization related tasks.
Contribute to process improvement efforts through feedback and suggestions.
Interested candidates share your resume to supraja@hamly.com
Job Types: Full-time, Permanent
Pay: ₹12,000.00 - ₹20,000.00 per month
Work Location: In person
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