Prior Authorisation QA in the Global Medical Process (Jobs - Full Time Jobs)
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Item ID 3353721 in Category: Jobs - Full Time Jobs
Prior Authorisation QA in the Global Medical Process | |
Prior Authorisation QA in the Global Medical Process Job Description Experience: 4+ yrs Salary: Based on Previous Experience Education: Any Basic Degree What You will do: Perform Quality Audits: You will conduct comprehensive quality audits on completed prior authorization requests before the patient encounter or claim submission. Ensure Data Integrity: You will meticulously review patient demographics, insurance eligibility, procedure codes, diagnosis codes, and clinical notes to ensure 100% accuracy and consistency with payer requirements. Monitor Compliance: You will verify that all authorization requests were submitted to the correct payer and follow-up was performed according to established internal and external procedures, including HIPAA regulations. Identify and Report Trends: You will track and analyze quality metrics, identifying systemic errors or training gaps within the PA team. You will prepare detailed reports on audit findings, denial patterns, and suggested process improvements. Drive Process Improvement: You will collaborate with the PA team, training department, and management to implement Corrective and Preventive Actions based on audit results to enhance overall quality and efficiency. Ready to take the leap HR - Maria 88708 33430 infohrmaria04@gmail.com | |
| Target State: Tamil Nadu Target City : Chennai Last Update : 09 October 2025 10:20 AM Number of Views: 19 | Item Owner : Maria Contact Email: Contact Phone: 8870833430 |
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2025-10-21 (0.385 sec)