About the Role:

Join the US Healthcare Revenue Cycle Management (RCM) team as an Operations Analyst – Prior Authorization. Selected candidates will receive structured training to ensure timely insurance approvals while maintaining compliance and service standards.

Key Responsibilities:

• Learn and perform Prior Authorization processes under senior guidance
• Review patient demographics, insurance details, and physician documentation
• Verify payer‑specific authorization requirements and medical necessity guidelines
• Submit authorization requests via portals, fax, phone, or electronic systems
• Follow up with insurance companies for timely approvals
• Document all activities accurately in client systems
• Monitor pending authorizations and ensure timely follow‑up
• Escalate complex or denied cases to senior analysts/team leaders
• Meet daily productivity, quality, and turnaround time targets
• Maintain confidentiality and comply with HIPAA regulations
• Participate in training, quality reviews, and improvement initiatives

Qualifications & Experience:

• Bachelor’s Degree, Diploma, or G.C.E. Advanced Level
• Minimum 1 year experience in Collections / Authorization
• Excellent verbal and written communication skills in English
• Strong analytical and problem‑solving skills
• High attention to detail
• Basic computer literacy (MS Office)
• Ability to work night shifts aligned with US business hours
• Basic understanding of US Healthcare/RCM (advantage, not mandatory)
• Previous exposure to customer service, BPO, or healthcare operations beneficial
• Immediate availability preferred