OnSure Health LLC is a U.S.-based healthcare solutions provider specializing in AI-driven healthcare support, revenue cycle management, and back-office solutions. We partner with hospitals, diagnostic centers, physician offices, and healthcare facilities to simplify financial and administrative operations while ensuring compliance and efficiency.
We are looking for a Prior Authorization Executive to handle pre-certifications, prior authorizations, and eligibility verification for U.S. healthcare clients. The role involves coordinating with insurance companies, providers, and patients to ensure timely approvals, reduce denials, and support smooth patient care delivery.
Initiate and complete prior authorization requests for medical procedures, medications, or services.
Verify patient insurance eligibility, benefits, and coverage details.
Contact insurance companies via phone, portals, and fax for authorization approvals.
Gather and review necessary medical documentation to support authorization requests.
Communicate with providers, patients, and insurance representatives regarding authorization status.
Track, follow up, and update prior authorization requests within timelines.
Maintain detailed records in the billing/authorization system.
Collaborate with billing, AR, and denial management teams to minimize claim denials.
Ensure compliance with HIPAA and client-specific guidelines.
Bachelor’s degree in Healthcare, Life Sciences, Business Administration, or related field.
1–3 years of experience in Prior Authorization / Pre-Certification / Medical Billing.
Familiarity with U.S. healthcare terminologies, CPT/ICD codes, and payer requirements.
Strong communication (verbal & written) skills to interact with insurance carriers and providers.
Proficiency in MS Office and medical billing/authorization software.
Ability to work night shifts (U.S. process).
Detail-oriented with strong organizational and problem-solving skills