Prior Authorization Analyst

Job Title: Prior Authorization Analyst (Immediate Joiners Preferred)

Location: WFO – Mohali

Department: RCM | US Healthcare

Experience: 2–5 Years

Shift: US Shift

Role Summary

We are hiring a Prior Authorization Analyst (US Healthcare) responsible for obtaining timely medical authorizations from insurance carriers, reviewing clinical documents, and ensuring approvals to reduce denials and secure accurate reimbursement.

Key Responsibilities

• Review patient clinical documents and verify insurance guidelines.
• Initiate and obtain prior authorizations via calls, payer portals, and fax.
• Follow up with insurance providers for pending approvals.
• Coordinate outcomes with providers, billing, and scheduling teams.
• Maintain accurate documentation in EMR/EHR systems.

Required Skills

• Minimum 2-year experience in Prior Authorization / Pre-cert / UM.
• Strong knowledge of CPT, HCPCS, ICD-10 & payer rules.
• Experience with payer portals & EMR (eCW, EPIC, Athena, etc.).
• Good communication & coordination skills.

Work Mode

Work From Office (WFO) – Mohali