Advantum Health Private Limited
Professional, Quality Analysis (PA)
Hyderabad, India
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hirly's read of this role
- Seniority
- Mid level
- Country
- IN
- Work mode
- On-site / unstated
- First seen by hirly
- 23 Sept 2026
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the posting
- Minimum of 2.5–5 years of experience in the healthcare industry, specifically in Prior Authorization .
- Proficient in CPT codes , diagnostic codes , and procedure or medication authorization across specialties such as Gastroenterology , Urology , Infusions , DME , and others.
- Solid understanding of co-pay and out-of-pocket expenses from an insurance standpoint.
- Skilled in using Microsoft Office Suite (Excel, Word, Outlook) and navigating the Internet effectively.
- Capable of handling confidential and sensitive information with discretion.
- Strong analytical skills to evaluate data and identify patterns or issues within the prior authorization workflow.
- Familiarity with medical terminology , insurance policies, and hospital billing procedures.
- High attention to detail and accuracy to ensure compliance with healthcare regulations and standards.
- Excellent verbal and written communication skills for effective interaction with healthcare providers, insurance companies, and internal teams.
- Problem-solving abilities to identify challenges and implement solutions that enhance the prior authorization process.
- Proficiency in using healthcare information systems and software related to prior authorization and claims processing.
- Collaborative mindset with the ability to work effectively in teams to streamline processes.
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