Fertility Prior Authorization Specialist, US Healthcare

Job Overview
SPCC Global is hiring an experienced Fertility Prior Authorization Specialist to support a US based healthcare client. This role focuses on managing fertility related prior authorizations with US insurance companies. The work is backend focused and handled through insurance portals and payer systems & patient calls.

We are looking for candidates who already have hands on experience with fertility prior authorizations. Candidates with IVF clinic or fertility billing experience will be preferred.

Key Responsibilities

• Submit fertility prior authorization requests through US insurance portals
• Review clinical documentation before submission
• Track authorization status and manage follow ups
• Work with US insurance payers and portals
• Verify CPT codes and ensure correct documentation
• Coordinate with billing and RCM teams
• Maintain accurate authorization records and updates

Required Experience

• Minimum 2 to 3 years experience in US Healthcare Prior Authorization
• Direct experience with fertility or IVF prior authorizations
• Strong knowledge of US insurance payer portals
• Experience working with fertility clinics, IVF centers, or reproductive health providers
• Understanding of CPT codes, medical terminology, and authorization workflows

Preferred Skills

• Experience with Texas based insurance payers
• Experience in US Medical Billing or RCM
• Familiarity with EMR and healthcare billing systems
• Strong attention to detail and accuracy

What We Offer

• Remote work environment
• Long term opportunity
• Competitive salary

Job Types: Full-time, Contract
Contract length: 12 months

Pay: Rs60,000.00 - Rs100,000.00 per month

Work Location: Remote