Prior Authorization Associate – Inbound Us Healthcare

Description:
Responsibilities:
Handle inbound provider calls for health insurance companies (based in US) for customer medical membership on High Deductible, EPO, PPO, HRA, and Idemnity plans for benefit verification/eligibility, claim status and general queries.
Answer calls and document as per customer’s written specifications in accordance to the process and procedure document.
Ensuring timely and accurate completion of transactions to meet or exceed client SLAs.
Responding to customer request via phone and/or writing to ensure timely resolution of unpaid medical insurance claims.
Analyzing medical insurance claims for quality resolution.
resolving complex situations following pre-established guidelines.
developing and maintaining a solid knowledge of healthcare insurance industry and of all products, services and processes performed by the team.
Organizing and completing tasks according to assigned priorities.

Requirements:
Skills:
1+ years of experience in global call center, where you had to correspond in writing or over the phone with customer or business associates who spoke English.
6+ months US Health Insurance inbound call center experience handling prior authorization
1+ yr(s) experience of using a computer with Windows PC applications that requires use of keyboard, navigation screens and learn new software tools.
1+ yr(s) experience in service-oriented role where you had to apply business rules to varying fact situations and making appropriate decisions.