Senior Medical Insurance Approvals Specialist

Job Overview We are seeking a highly skilled professional to lead the medical insurance approvals process. This involves reviewing and verifying pre-approval requests, applying medical knowledge, and ensuring compliance with regulatory standards.The ideal candidate will have expertise in claim adjudication rules and business practices.Key responsibilities include handling rejected pre-authorizations, obtaining justification from treating doctors, and resending them to insurance companies for approval.This role also entails supervising and managing an authorization team to ensure efficient processing of pre-authorization requests.Requirements: Expertise in claim adjudication rules and business practices Strong understanding of medical knowledge and regulatory standards Ability to handle rejected pre-authorizations and obtain justification Effective communication and leadership skills Benefits: Opportunity to work in a dynamic environment Chance to develop expertise in medical insurance approvals Collaborative team environment Note: Only qualified candidates will be contacted for further consideration.