Urgent Requirement QA Prior Authorization (Executive & Sr. Executive, Lateral Roles)

Urgent Requirement – QA Prior Authorization (Executive & Sr. Executive, Lateral Roles)

Job Title: Executive / Senior Executive – QA Prior Authorization

Job Description:

We are looking for Executives (1 to 3 years) and Senior Executives (4 to 6 years) with experience in QA for Prior Authorization. The role involves ensuring accuracy, compliance, and quality in prior authorization processes, supporting error-free claim submissions, and improving operational efficiency. Candidates must be open to night shifts; 2-way cab facility is provided. Immediate joiners are preferred.

Key Responsibilities:

Conduct quality audits for prior authorization requests.

Verify accuracy of medical necessity, insurance requirements, and documentation.

Ensure compliance with payer guidelines and US healthcare standards.

Identify process gaps and share feedback with the operations team.

Collaborate with internal teams, providers, and insurers to resolve issues.

Maintain HIPAA compliance and confidentiality of patient information.

For Senior Executives: mentor team members and support process improvements.

Requirements:

Graduate in any stream (life sciences/pharmacy background preferred).

1 to 3 years of experience for Executive level.

4 to 6 years of experience in QA Prior Authorization for Senior Executive level.

Strong knowledge of US healthcare, insurance guidelines, and prior authorization processes.

Good analytical, problem-solving, and communication skills.

Flexible to work in night shift.

Perks:

Night shift allowance.

2-way cab facility.

Growth opportunities in healthcare QA.

Location: Chennai

Qualification: B.E, B. Tech

Salary: As Per Company Standard

Regards,

Amirtha HR

85240-79811