Maharashtra Prior authorization specialist Jobs – 10 Open Jobs Today

Prior Authorization - Radiology
Risa Labs —Pune, Maharashtra
- ₹3,00,000 - ₹7,00,000 a year
- Full-time
- HIPAA
- 12th Pass
- EMR systems
- Health insurance
Quick apply
2d
Revenue Cycle Management (RCM)
Ibraniac software —Clark Town, Nagpur, Maharashtra
- ₹20,000 - ₹30,000 a month
- Full-time
- English
- Analysis skills
- Data entry
- Work from home
Quick apply
2d
Assistant Manager OQ – Batch Release & Engineering Oversight
GlaxoSmithKline —Nashik, Maharashtra
- Full-time
- Microsoft Powerpoint
- Microsoft Excel
- B.Sc
2d
Lead Business Analyst
Biyani Technologies Pvt Ltd —Kolhapur, Maharashtra
- Full-time
- Hybrid work
- Analysis skills
- Bachelor's degree
Quick apply
Sr Clinical Operation Specialist / Lead Clinical Operation Specialist (immediate Joiner)
サイネオス・ヘルス —Pune, Maharashtra
- English
- Communication skills
Salesforce Agentforce Developer
Jade Global —Pune, Maharashtra
- Full-time
- Salesforce
- Master's degree
- Bachelor's degree
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Contractor, Digital Marketing
Cactus Communications Services Pte. Ltd. —Mumbai Suburban District, Maharashtra
- Bachelor's degree
- Marketing

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Based on your search for prior authorization specialist

Revenue Cycle Management (RCM)
Ibraniac software —Clark Town, Nagpur, Maharashtra
Front-End RCM: Patient registration and accurate demographic data entry Insurance verification and eligibility checks Prior authorization and pre-certification…
₹20,000 - ₹30,000 a month
Quick apply
2d
Prior Authorization - Radiology
Risa Labs —Pune, Maharashtra
Review Authorization Requests:* Review radiology prior authorization requests to verify medical necessity and ensure they meet payer-specific guidelines and…
₹3,00,000 - ₹7,00,000 a year
Quick apply
2d

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Prior Authorization jobs in Pune, Maharashtra

Prior Authorization - Radiology

Risa Labs
Pune, Maharashtra

Quick apply

Job details

Full-time | Contractual / Temporary
₹3,00,000 - ₹7,00,000 a year
2 days ago

Benefits

Health insurance

Qualifications

HIPAA
12th Pass
EMR systems
Epic
Communication skills
Office experience

Full job description

Radiology Prior Authorization Specialist

Role Overview

We are seeking a detail-oriented Radiology Prior Authorization Specialist to manage and streamline the prior authorization (PA) process for radiology treatments, procedures, and imaging services. In this role, you will ensure timely and accurate approvals while maintaining compliance with insurance guidelines and radiology-specific requirements. You will collaborate with radiologists, physicians, nursing staff, and insurance payers to facilitate access to necessary diagnostic imaging and related services.

Responsibilities

Manage Prior Authorization Process: Oversee the entire prior authorization process for radiology-related procedures, including imaging services such as MRIs, CT scans, X-rays, and other diagnostic tests, ensuring efficient and timely approvals.

Review Authorization Requests: Review radiology prior authorization requests to verify medical necessity and ensure they meet payer-specific guidelines and criteria for approval.

Collaborate with Care Teams: Work closely with radiologists, physicians, nursing staff, and other medical personnel to gather clinical documentation and ensure it is submitted promptly and accurately.

Insurance Coordination: Liaise with insurance companies to resolve issues related to coverage, denials, and appeals, ensuring that the authorization process is seamless and that patients can access the necessary radiology services without delays.

Record Keeping: Maintain accurate and organized records of all prior authorization requests, approvals, denials, and appeals, ensuring compliance with regulatory standards and easy retrieval of information.

Proactive Issue Resolution: Identify and address any barriers to the timely processing of radiology prior authorizations, working proactively to resolve payer-specific requirements or challenges.

Stay Informed: Stay updated on insurance policy changes, payer guidelines, and emerging radiology treatments to ensure that all prior authorization requests are in compliance and processed correctly.

Provide Insights: Offer feedback and support to radiology care teams to improve workflow efficiency and minimize delays in service delivery.

Utilize Technology: Leverage electronic medical records (EMR) systems and prior authorization platforms to streamline processes and ensure smooth communication with insurance payers.

Compliance: Ensure all communications, documentation, and processes comply with HIPAA and other relevant regulations.

Qualifications

Experience: Minimum of 3 years of experience in managing prior authorizations,specifically for radiology services and imaging procedures.

Preferred Experience: Experience working with radiology departments or in a clinical environment is highly preferred.

Knowledge: In-depth knowledge of radiology procedures, diagnostic imaging services,and insurance requirements for medical prior authorizations.

Insurance & Reimbursement: Strong understanding of insurance policies,reimbursement processes, and medical necessity criteria related to radiology services.

Technical Proficiency: Proficiency with EMR systems (e.g., Epic, Cerner, or similar)and prior authorization platforms used for submitting and tracking radiology requests.

Communication Skills: Excellent communication and interpersonal skills, with the ability to effectively liaise with healthcare teams, patients, and insurance payers.

Detail-Oriented: Exceptional attention to detail, with the ability to manage complex documentation and maintain organized records.

Independent & Collaborative: Ability to work both independently and as part of a team, particularly in a fast-paced healthcare environment.

Compliance Knowledge: Strong knowledge of HIPAA compliance and other regulatory standards affecting medical and radiology services.

Preferred Certifications: Certification in Medical Coding, Radiology, Healthcare Administration, or related field is a plus.

Pay: ₹300,000.00 - ₹700,000.00 per year

Work Location: In person

Quick apply

Refine Your Search

prior authorization specialist jobs in maharashtra

Prior Authorization - Radiology

Revenue Cycle Management (RCM)

Assistant Manager OQ – Batch Release & Engineering Oversight

Lead Business Analyst

Sr Clinical Operation Specialist / Lead Clinical Operation Specialist (immediate Joiner)

Salesforce Agentforce Developer

Contractor, Digital Marketing

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