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Job Description
Responsible for providing quality service to clients by promptly and effective assessing and processing pre-authorizations and medical approvals according to the company polices and procedures and contracts terms with clients.
- Evaluate Medical requests and provide authorizations for insured members.
- Answer prior approval received from medical providers within the previously agreed SLA.
- Apply strong medical knowledge to detect any abuses or investigation not related to medical condition
- Make sure that planned treatment is within reasonable and customary costs.
- Maintain high level of communication with the client and develop a following – up process.
- Finalizing all the medical requests coming through different communication channels.
Job Requirements
- Faculty Of Medicine
- Experience 1to 2 years
