Prior Authorization Analyst

Role overview

This position is for a Prior Authorization Analyst in US healthcare operations. The role focuses on securing medical approvals from insurance carriers on time, checking clinical records, and helping prevent claim denials so that reimbursement is handled correctly.

Key responsibilities

• Examine patient clinical records and confirm that they align with insurance policy requirements.
• Submit and secure prior authorization requests through phone calls, payer portals, and fax.
• Track unresolved cases and follow up with insurers until a decision is received.
• Work closely with providers, billing teams, and scheduling teams to communicate authorization status and next steps.
• Record all updates accurately in EMR/EHR platforms.

Experience and skills

The employer prefers candidates with 2 to 5 years of experience, and specifically seeks immediate joiners. Applicants should have at least 2 years of hands-on exposure to prior authorization, pre-certification, or utilization management work. Familiarity with CPT, HCPCS, ICD-10, and payer regulations is important, along with practical experience using payer portals and EMR systems such as eCW, EPIC, and Athena. Strong communication and coordination abilities are also expected.

Work arrangement

This is a work-from-office role based in Mohali, and the shift follows US working hours.