Job Description
Full job description
Opening Position : QA | Authorization specialist | Team Leader
Experience : 0 - 10 yrs
Role & responsibilities
i)Verifies patient insurance eligibility and benefits information from the insurance carrier.,
ii) Identify primary and secondary payor or additional payor, based on established payer coverage guidelines and criteria.
iii) Completes accurate and timely third party payer authorization requests, including ensuring all necessary data elements needed for an authorization (e.g., CPT codes, diagnosis codes) are available.
iv)Handle Authorization submissions and follow ups for all Insurance Payors including Medicare, Medicaid's, HMO and PPOs.
v)Ensured proper clinical documentation was in place as needed to obtain pre- auth and queried provider clarity.
vi)Request retro authorization when it needed.
vii)Identify insurance treatment requirements and review the medical records to assure the insurance requirements are met for prior authorization approval.
viii)Contact the payor for status of outstanding/pending Authorization requests.
ix) Ensure that all assigned Authorizations are resolved within appropriate time.
x)Communicates with practices when prior authorization is unable to be obtained and requires peer to peer or different study.
xi)Monitor closely rejection from the clearing houses and denials from the insurance carrier. Maintains productivity and quality performance expectations.
xii) Generation of QA reports on a daily basis.
xiii) Provide inputs to the training team on common mistakes made to enhance training curriculum.
Preferred candidate profile
2+ years of professional experience in US Healthcare Industry.
Good knowledge of RCM, Eligibility Verification & Authorization
Strong written and oral communication skills.
Quality Feedback/Refresher session
Prepare and Maintain Quality status reports.
Job Types: Full-time, Permanent
Pay: ₹13,+26.56 - ₹32,141.65 per month
Benefits:
Health insurance
Provident Fund
Work from home
Schedule:
Day shift
Night shift
Experience:
authorization in US healthcare: 1 year (Required)
Work Location: In person
Expected Start Date: 12/06/2026
Opening Position : QA | Authorization specialist | Team Leader
Experience : 0 - 10 yrs
Role & responsibilities
i)Verifies patient insurance eligibility and benefits information from the insurance carrier.,
ii) Identify primary and secondary payor or additional payor, based on established payer coverage guidelines and criteria.
iii) Completes accurate and timely third party payer authorization requests, including ensuring all necessary data elements needed for an authorization (e.g., CPT codes, diagnosis codes) are available.
iv)Handle Authorization submissions and follow ups for all Insurance Payors including Medicare, Medicaid's, HMO and PPOs.
v)Ensured proper clinical documentation was in place as needed to obtain pre- auth and queried provider clarity.
vi)Request retro authorization when it needed.
vii)Identify insurance treatment requirements and review the medical records to assure the insurance requirements are met for prior authorization approval.
viii)Contact the payor for status of outstanding/pending Authorization requests.
ix) Ensure that all assigned Authorizations are resolved within appropriate time.
x)Communicates with practices when prior authorization is unable to be obtained and requires peer to peer or different study.
xi)Monitor closely rejection from the clearing houses and denials from the insurance carrier. Maintains productivity and quality performance expectations.
xii) Generation of QA reports on a daily basis.
xiii) Provide inputs to the training team on common mistakes made to enhance training curriculum.
Preferred candidate profile
2+ years of professional experience in US Healthcare Industry.
Good knowledge of RCM, Eligibility Verification & Authorization
Strong written and oral communication skills.
Quality Feedback/Refresher session
Prepare and Maintain Quality status reports.
Job Types: Full-time, Permanent
Pay: ₹13,+26.56 - ₹32,141.65 per month
Benefits:
Health insurance
Provident Fund
Work from home
Schedule:
Day shift
Night shift
Experience:
authorization in US healthcare: 1 year (Required)
Work Location: In person
Expected Start Date: 12/06/2026
💡 Quick Summary
Seeking a career-building opportunity? The Authorization Specialist position is now open for candidates interested in the Work from home Jobs sector. This role in Keeranatham, Coimbatore, Tamil Nadu offers a professional environment and growth potential.
Requirement Snapshot: Candidates should possess basic communication skills, a proactive attitude, and the ability to work in a team. Experience in Work from home Jobs is a plus.
