Job Description

Title: Advisor – Pre-AuthorizationLocation: Kuala Lumpur, MalaysiaExperience: 0-5 YearsSummary of the Role:The Case Management Advisor is responsible for Pre-Authorization process from members & medical providers to ensure that medical treatments, procedures, or medications requiring prior approval are authorized. This role is critical in streamlining the healthcare process, ensuring timely patient care, and facilitating proper reimbursement while adhering to insurance policies and regulatory guidelines.List of Duties:Review and assess pre-authorization (PA) requests from members or providers for completeness, accuracy, and eligibility in accordance with policy terms and conditions.Verify medical charges against appropriate diagnosis, procedure, and medical codes to ensure consistency and compliance.Communicate Pre-authorization results to members or providers within the service level agreementsRequest additional information or clarification from members or providers to support PA decisionsEscalating complex or exceptional cases to senior advisors or supervisors as neededDesired Professional Experience:With 0-5 years of experience in Pre-authorization or medical claims processingWith Healthcare background is preferredWith knowledge of medical terminology, billing codes (ICD 9, ICD 10, CPT) and medical insurance polices is preferredGood time management skill and ability to multitaskProficient in Cantonese, Mandarin, and English (speak, read, and write).About Cognizant:Cognizant (Nasdaq: CTSH) engineers modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we're improving everyday life. See how at www.cognizant.com or @cognizant.#LI-CTSAPAC The Cognizant community: We are a high caliber team who appreciate and support one another. Our people uphold an energetic, collaborative and inclusive workplace where everyone can thrive. Cognizant is a global community with more than 300,000 associates around the world. We don’t just dream of a better way – we make it happen. We take care of our people, clients, company, communities and climate by doing what’s right. We foster an innovative environment where you can build the career path that’s right for you. About us: Cognizant is one of the world's leading professional services companies, transforming clients' business, operating, and technology models for the digital era. Our unique industry-based, consultative approach helps clients envision, build, and run more innovative and efficient businesses. Headquartered in the U.S., Cognizant (a member of the NASDAQ-100 and one of Forbes World’s Best Employers 2024) is consistently listed among the most admired companies in the world. Learn how Cognizant helps clients lead with digital at www.cognizant.com Cognizant is an equal opportunity employer. Your application and candidacy will not be considered based on race, color, sex, religion, creed, sexual orientation, gender identity, national origin, disability, genetic information, pregnancy, veteran status or any other characteristic protected by federal, state or local laws. Disclaimer: Compensation information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law. Applicants may be required to attend interviews in person or by video conference. In addition, candidates may be required to present their current state or government issued ID during each interview.

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