Mumbai Maharashtra Verification specialist Jobs – 129 Open Jobs Today

Manager - Prior Authorization ( Mumbai)
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Quick apply
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Manager - Prior Authorization ( Mumbai)

Eclat Health Solutions -
Mumbai, Maharashtra

Quick apply

Job details

2 hours ago

Qualifications

Revenue cycle management
Management
Analysis skills
Team management
CPT coding
Billing
Communication skills

Full job description

Job Title: Manager - Prior Authorization

Location: Mumbai

Experience: 10+ Years (Minimum 1 Year as Operations Manager)

Job Summary

We are seeking an experienced Prior Authorization Manager with strong expertise in managing end-to-end Prior Authorization operations across Physician Billing specialties. The ideal candidate will lead large teams, ensure timely authorization approvals, optimize workflows, and drive operational excellence while maintaining compliance with payer and client requirements.

Key Responsibilities

Lead and manage a team of Prior Authorization Specialists handling multiple physician specialties
Oversee end-to-end Prior Authorization processes, including eligibility verification, authorization submissions, follow-ups, and approvals
Ensure timely submission and tracking of authorization requests to prevent delays in patient care and claim reimbursement
Manage escalations related to authorization denials, medical necessity requirements, and payer-specific guidelines
Monitor team performance against KPIs, SLAs, quality metrics, and productivity targets
Identify process gaps and implement operational improvements to enhance efficiency and turnaround times
Provide floor support, coaching, training, and mentoring to team members
Ensure adherence to client requirements, payer policies, HIPAA, and compliance standards
Collaborate with providers, clinical teams, and payer representatives to resolve authorization-related issues
Prepare and present daily, weekly, and monthly performance reports and operational dashboards

Required Skills & Expertise

Strong domain knowledge in Prior Authorization for Physician Billing
Hands-on experience with authorization submissions, follow-ups, and denial resolution
Good understanding of CPT, ICD-10, HCPCS codes, modifiers, and medical necessity criteria
Experience working with Medicare, Medicaid, and Commercial payers
Strong knowledge of payer authorization requirements, turnaround times, and escalation processes
Ability to analyze authorization trends and implement corrective actions
Excellent team management, stakeholder engagement, and client communication skills
Strong analytical, reporting, and problem-solving abilities

Preferred Qualifications

Prior experience managing a team of 100+ Prior Authorization Specialists
Exposure to client interactions, business reviews, and escalation management
Experience with multiple specialties such as Radiology, Oncology, Cardiology, Orthopedics, Pain Management, and Surgery
Knowledge of Revenue Cycle Management (RCM) processes and payer portals

Notice Period: Immediate to 30 Days Preferred.

Quick apply

Refine Your Search

verification specialist jobs in mumbai maharashtra

Manager - Prior Authorization ( Mumbai)

Deputy Application Manager IVD

Relationship Manager - Wealth Management

Project Manager - HSE (Data Center)

HR Executive and Recruiter

Cyber Intelligence Specialist

Principal Engineer – Drainage

Associate/Technical Lead-Ecology

ID - Rack Lifecycle Tech, Rack Lifecycle Team

Signage & Wayfinding Designer

Rates Strats VP

Assistant Engineer - Water

Latin Translator

Senior Account Manager

Rajasthani Interpreter

Campaign Manager

Senior Technical Reviewer

Kurdish Translator

Assamese Translator

Malayalam Writer

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Job Title: Manager - Prior Authorization

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