About this role
Handling the rejected pre-authorization and get required justification from the treating doctor to resend it to Insurance Company and obtain the approval.
Ensure that the details of the Pre-Authorization Requests are in line with the regulators’ standards especially the claim adjudication Rules and Business Rules.
- College Diploma - Any discipline or related fields.
- Proficiency in medical coding standards: ICD, CPT, DRG, HCPCS
Experience in insurance claims management or pre-authorization (approval) processes, typically 2+ years