R1 RCM is hiring for the Authcreate Process in Gurugram. The role involves creating prior authorizations on behalf of physicians by reviewing patient medical records and clinical documentation, interacting with US health insurance representatives, and securing approvals for procedures.
Job Details
| Details | Information |
|---|---|
| Company | R1 RCM |
| Role | Authcreate Process |
| Location | Gurugram, Haryana |
| Experience | 1–5 years |
| Salary | ₹2–5.5 Lacs P.A. |
| Openings | 5 |
| Employment Type | Full Time, Permanent |
| Industry | BPM / BPO |
| Department | Healthcare & Life Sciences |
| Role Category | Healthcare & Life Sciences – Other |
| Work Shifts | 6 PM–3 AM and 9 PM–6 AM |
| Education | Graduation mandatory |
Positions
R1 RCM is hiring candidates for the Authcreate Process, supporting US healthcare operations in the EST time zone.
Responsibilities
Selected candidates will be responsible for:
- Creating prior authorizations on behalf of physicians.
- Reviewing patient medical records and clinical documentation.
- Interacting with US health insurance companies, including Insurance Customer Care, Nurses, and UM Teams.
- Securing approvals for procedures.
- Reading clinical documentation and entering data according to payer requirements.
- Obtaining relevant health insurance information of patients.
- Working on websites and applications according to the applicable SOP.
- Accurately interpreting clinical reports, physician notes, and diagnostic results.
Eligibility & Qualifications
Graduation is mandatory.
Eligible undergraduate qualifications include:
- BDS – Bachelor of Dental Surgery
- Bachelor of Physiotherapy
- B.Sc in Clinical Pathology
- B.Sc in Radiology and Medical Imaging
- B.Sc in Biotechnology
- B.Sc in Life Science
- B.Sc in Medical Laboratory Technology (MLT)
- B.Pharma in Any Specialization
Candidates with 1–5 years of experience are eligible for the role.
Required Skills
Candidates should have:
- Strong understanding of medical terminology.
- Knowledge of anatomy and common medical procedures.
- Ability to interpret clinical reports.
- Ability to understand physician notes and diagnostic results accurately.
- Ability to read clinical documentation.
- Good data-entry skills for payer requirements.
- Understanding of US healthcare and authorization processes.
Work Timings
The role supports US operations in the EST zone. The mentioned shifts are:
- 6:00 PM to 3:00 AM
- 9:00 PM to 6:00 AM