Job Summary
The AR Caller – Prior Authorization is responsible for verifying, obtaining, and following up on prior authorizations with insurance payers to ensure timely claim processing and payment. The role involves close coordination with providers, payers, and internal teams to reduce denials and improve revenue cycle performance.
Key Responsibilities
- Verify prior authorization requirements for scheduled services and procedures
- Obtain prior authorizations from insurance companies via calls, portals, and fax
- Follow up with payers on pending authorization requests
- Document authorization numbers, status, and notes accurately in the system
- Coordinate with clinical, billing, and coding teams for required medical documentation
- Identify authorization-related denials and work on resolution
- Maintain TAT and productivity standards as defined by the process
- Ensure compliance with HIPAA and payer-specific guidelines
Required Skills & Qualifications
- Experience in US Healthcare AR Calling or Prior Authorization
- Strong knowledge of insurance portals, CPT/ICD codes, and payer rules
- Excellent verbal and written communication skills
- Ability to handle high call volumes and follow-up efficiently
- Attention to detail and strong documentation skills
Preferred Qualifications
- Experience with Medicare, Medicaid, and Commercial payers
- Familiarity with EHRs and practice management systems
- Knowledge of denial management related to prior authorization
Education
- Any Graduate / Undergraduate (Healthcare background preferred)
Pay: ₹12,954.43 - ₹38,419.00 per month
Work Location: In person
