Job Opportunities

Authorisation Specialist

Job Summary

We are seeking a detail-oriented Authorization Specialist with hands-on experience in Revenue Cycle Management (RCM). The ideal candidate must have strong expertise in Verification of Benefits (VOB), insurance eligibility verification, and obtaining prior authorizations to ensure timely processing of patient services and minimize claim denials.

Key Responsibilities

Perform Verification of Benefits (VOB) for patients by contacting insurance providers and reviewing payer portals.
Verify patient insurance eligibility, coverage, deductibles, co-pays, co-insurance, and out-of-pocket responsibilities.
Obtain and manage prior authorizations for medical procedures, treatments, medications, and diagnostic services.
Ensure all authorization requirements are met before scheduled services.
Communicate authorization status and benefit details to internal teams and patients when required.
Follow up with insurance companies on pending authorization requests.
Maintain accurate documentation of benefit verification and authorization details in the practice management/EHR system.
Identify and resolve authorization-related issues to prevent claim denials and delays.
Stay updated on payer policies, insurance guidelines, and regulatory requirements.
Collaborate with clinical, billing, and coding teams to ensure seamless revenue cycle operations.

Mandatory Requirements

Minimum 1–5+ years of experience in Revenue Cycle Management (RCM).
Mandatory hands-on experience in Verification of Benefits (VOB).
Experience with Prior Authorization processes.
Strong understanding of commercial insurance, Medicare, Medicaid, and managed care plans.
Experience working with insurance portals and provider websites.
Excellent verbal and written communication skills.
Strong analytical and problem-solving abilities.
High attention to detail and accuracy.

Preferred Skills

Knowledge of US Healthcare and Medical Billing processes.
Familiarity with CPT, ICD-10, and HCPCS codes.
Experience with EMR/EHR and Practice Management systems.
Ability to work in a fast-paced, target-driven environment.
Strong organizational and time management skills.

Educational Qualification

Bachelor's degree or equivalent.
Certification in Medical Billing/Coding or RCM is an added advantage.