Prior Authorization Specialist

We are seeking an experienced Prior Authorization Specialist to manage and process insurance prior authorization requests efficiently. The ideal candidate must have strong knowledge of U.S. healthcare insurance guidelines and ensure timely approvals to avoid treatment delays and claim denials.

Key Responsibilities

• Process prior authorization requests for medical procedures, treatments, medications, and diagnostic services
• Verify patient insurance eligibility and benefits
• Communicate with insurance companies (Medicare, Medicaid, Commercial Plans)
• Submit clinical documentation to insurance payers as required
• Follow up on pending authorizations and resolve denials
• Coordinate with physicians, medical staff, and billing teams
• Maintain accurate authorization records in EMR/EHR systems
• Ensure compliance with HIPAA and insurance regulations
• Meet turnaround time (TAT) and productivity targets

Required Experience & Qualifications

• Minimum 1–2 years of Prior Authorization experience (mandatory)
• Strong understanding of US Healthcare & Insurance Policies
• Familiarity with CPT, ICD-10, and HCPCS codes
• Experience with EMR/EHR systems
• Excellent verbal and written English communication skills
• Ability to work under pressure and meet deadlines

Skills & Competencies

• Insurance verification & authorization handling
• Denial management & follow-ups
• Attention to detail
• Multitasking & time management
• Professional communication with payers and providers

Job Type

• Full-time
• Johar Town Lahore

Job Type: Full-time

Pay: Rs180,000.00 - Rs220,000.00 per month

Work Location: In person