Job Title: Prior Authorization Analyst (Immediate Joiners Preferred)
Location: WFO – Mohali
Department: RCM | US Healthcare
Experience: 2–5 Years
Shift: US Shift
Role Summary
We are hiring a Prior Authorization Analyst (US Healthcare) responsible for obtaining timely medical authorizations from insurance carriers, reviewing clinical documents, and ensuring approvals to reduce denials and secure accurate reimbursement.
Key Responsibilities
Review patient clinical documents and verify insurance guidelines.
Initiate and obtain prior authorizations via calls, payer portals, and fax.
Follow up with insurance providers for pending approvals.
Coordinate outcomes with providers, billing, and scheduling teams.
Maintain accurate documentation in EMR/EHR systems.
Required Skills
Minimum 2-year experience in Prior Authorization / Pre-cert / UM.
Strong knowledge of CPT, HCPCS, ICD-10 & payer rules.
Experience with payer portals & EMR (e CW, EPIC, Athe...