The Pre-Authorization Specialist is a member of the Pre-Authorization Department who is responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services.
This individual determines which patient services have third-party payer requirements and is responsible for obtaining the necessary authorizations for care.
The Pre-Authorization Specialist provides detailed and timely communication to both payers and clinical partners in order to facilitate compliance with payer contractual requirements and is responsible for documenting the appropriate information in the patient's record.
Other duties as assigned.

The Pre-Authorization Specialist is a member of the Pre-Authorization Department who is responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services.
This individual determines which patient services have third-party payer requirements and is responsible for obtaining the necessary authorizations for care.
The Pre-Authorization Specialist provides detailed and timely communication to both payers and clinical partners in order to facilitate compliance with payer contractual requirements and is responsible for documenting the appropriate information in the patient's record.
Other duties as assigned.

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About Technocruitx universal services pvt ltd

Founded :

2017

Type :

Products & Services

Size :

20-100

Stage :

Profitable

About

Technocruitx is a multi-service company that offers Recruitment, Technology and Healthcare RCM Services. ➤Recruitment Services: This service involves helping businesses find and hire the right talent for their specific needs. This service includes Permanent Recruitment, Staff Outsourcing and Payroll & HR Process Outsourcing. ➤Technology Services: Technology services can encompass various IT-related offerings. These services include Web Development, Mobile App Development, Software Product Development, Digital Marketing Services and UI/UX Design Services. ➤Healthcare RCM Services: Healthcare RCM services are crucial for healthcare providers to optimize revenue streams. This service involves Core offers such as Medical billing, Dental Billing, Revenue Analytics, Medical Coding, Charge Posting, Payment Posting, Claims Denials/Appeal Management, Credentialing and Many More. Feel free to contact us on Email: info@technocruitx.com Phone: 079-48939912

Tabassum Malek

Rimpal Patel

Ensu Varkey

dolly sharma

JANKI THAKAR

Keya Patel

Ruchi Bhatt

Ravina Gohil

Company social profiles

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Spread the word about best practices in software development inside and outside
Equal Experts community like Expert Talks

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Testing tools like Jasmine, Jest, Enzyme
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Tasks to be performed single handedly

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What you need to have:

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What you will do:

Business & Financial Management :

Ensure forms / returns / registers are prepared accurately and filed timely.
Ensure creation and maintenance of secretarial records / registers and ensure that they remain updated all the time.
Assist / ensure listing, tracking and compliance with the statutory provisions under the Company law, SEBI / NHB / RBI / IRDA laws / related laws and
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Prepare all relevant meetings’ documents/papers efficiently.
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Ensure all the audits are completed in time and always aim for clean audit reports.
Assist in carrying out all other compliances and assignments as may be delegated from time to time in accurately and efficiently.
Implementing processes or systems to help ensure good management of the organisation or compliance with the legislation.
Keeping up to date with any regulatory or statutory changes and policies that might affect the organisation.

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Ensure prompt and effective coordination in a cordial manner.
Build and maintain cordial relations with all internal and external stakeholders statutory authorities, stock exchanges, Debenture Trustees, R&T agents,
Consultants, Regulators, Other departments, etc.
Prepare training plans for the juniors and track their progress. To help them handle assignments independently.
Provide qualitative and timely assistance to seniors whenever called for
Process / Quality Improvement.
Finalising and submitting process manuals, checklists, trackers etc.
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Accurately prepare, finalise and submit process manuals, checklists, trackers, etc in time.
Assist in improving the compliance and administrative processes continually.

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Tasks to be performed single handedly

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What you need to have: