About Us - www.Autismcoe.com
Autism Center of Excellence is a growing organization specializing in Applied Behavior Analysis (ABA) services across the United States. We are committed to delivering exceptional healthcare support services while maintaining the highest standards of operational excellence, compliance, and client satisfaction.
As part of our continued growth, we are looking for an experienced Process Associate – Authorization & Eligibility to join our Revenue Cycle Management (RCM) team and support our US healthcare operations.
Role Overview
We are seeking a detail-oriented and motivated Process Associate with 2–5 years of experience in Prior Authorization and Insurance Eligibility Verification within the US Healthcare Revenue Cycle Management (RCM) industry.
The ideal candidate should possess strong knowledge of insurance verification processes, payer guidelines, authorization requirements, benefits verification, and excellent communication skills to ensure timely approvals and seamless patient care.
Key ResponsibilitiesPrior Authorization
- Submit prior authorization requests to commercial and government insurance payers.
- Verify authorization requirements based on CPT, HCPCS, ICD-10, and payer-specific guidelines.
- Follow up with insurance companies to obtain timely authorization approvals.
- Maintain authorization records and ensure approvals are received before scheduled services.
- Coordinate with internal departments regarding authorization status and pending documentation.
- Escalate delayed or denied authorization requests to appropriate stakeholders.
Eligibility & Benefits Verification
- Verify patient insurance eligibility and coverage before scheduled appointments.
- Review patient benefits, deductibles, copays, coinsurance, out-of-pocket expenses, and policy limitations.
- Identify primary and secondary insurance coverage.
- Verify provider participation (In-Network/Out-of-Network) with insurance plans.
- Ensure accurate documentation of insurance verification within the system.
Documentation & Compliance
- Maintain accurate documentation of verification and authorization activities.
- Ensure compliance with HIPAA regulations and company policies.
- Follow payer-specific policies and maintain process accuracy.
- Support internal audits and quality assurance initiatives.
Reporting & Process Improvement
- Prepare daily productivity reports and work logs.
- Identify recurring authorization or eligibility issues and recommend process improvements.
- Meet assigned productivity and quality targets.
Requirements
- Minimum 2–5 years of experience in US Healthcare RCM.
- Hands-on experience in:
- Prior Authorization
- Eligibility Verification
- Benefits Verification
- Good understanding of:
- CPT Codes
- ICD-10 Codes
- HCPCS Codes
- Insurance Portability & HIPAA Guidelines
- Knowledge of Medicare, Medicaid, and Commercial Insurance plans.
- Excellent verbal and written English communication skills.
- Strong analytical and problem-solving abilities.
- Ability to work independently and manage multiple priorities.
- Proficiency in MS Excel, MS Outlook, Google Workspace, and healthcare portals.
- Willingness to work in the US Night Shift.
Preferred Qualifications
- Experience in ABA Therapy or Behavioral Health billing is preferred.
- Experience using payer portals and EMR/EHR systems.
- Familiarity with Availity, Waystar, Office Ally, CR, or similar healthcare portals.
- Strong understanding of authorization turnaround timelines and payer policies.
Work Details
Job Type: Full-time
Work Mode: On-site (In-office)
Location: Sector 74, Mohali, Punjab
Shift Timing: 6:00 PM – 3:30 AM (US Night Shift / EST Support)
Working Days: Monday to Friday (Saturday & Sunday Fixed Off)
Important Note (Please Read Before Applying)
This position is based in our Mohali office and requires working during the US Night Shift.
Please note:
- This is strictly an in-office position.
- Work From Home (WFH) is not available.
- The company currently does not provide cab or meal facilities.
- Candidates must arrange their own transportation to and from the office.
- Candidates should be comfortable working in a night shift before applying.
Only candidates who meet these conditions are encouraged to apply.
Why Join Us
- Opportunity to work with a rapidly growing US Healthcare organization.
- Exposure to international healthcare operations and insurance processes.
- Structured career progression within Revenue Cycle Management.
- Performance-driven work culture.
- Learning and development opportunities.
- Stable long-term career growth.
Contact
Autism Center of Excellence
Website: www.autismcoe.com
Email: [email protected]
Pay: ₹25,000.00 - ₹45,000.00 per month
Work Location: In person
