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authorization specialist

Speak Viral

The Authorization Expert is responsible for obtaining, verifying, and managing prior authorizations for medical services to ensure timely reimbursement and compliance with payer requirements. This role works closely with providers, billing teams, insurance companies, and patients to prevent claim denials and delays related to authorization issues.Key Responsibilities<ul><li>Obtain prior authorizations, referrals, and pre-certifications from insurance payers for medical procedures, treatments, and diagnostic services</li><li>Verify patient insurance eligibility, benefits, coverage limits, and authorization requirements</li><li>Review physician orders and clinical documentation to ensure accuracy and compliance with payer guidelines</li><li>Communicate with insurance companies to follow up on authorization status, appeals, and approvals</li><li>Document authorization details accurately in billing and practice management systems</li><li>Identify and resolve authorization-related denials and underpayments</li><li>Collaborate with providers and billing teams to ensure services are rendered within authorization guidelines</li><li>Stay current with payer policies, authorization rules, and regulatory changes</li><li>Maintain compliance with HIPAA and organizational policies</li><li>Meet productivity, accuracy, and turnaround time standards</li></ul>Required Qualifications<ul><li>2+ years of experience in medical billing, insurance verification, or prior authorizations</li><li>Strong knowledge of insurance plans (commercial, Medicare, Medicaid, managed care)</li><li>Familiarity with CPT, ICD-10, and HCPCS codes</li><li>Experience working with EMR/EHR and medical billing software</li><li>Strong attention to detail and organizational skills</li><li>Excellent verbal and written communication skills</li></ul>Preferred Qualifications<ul><li>Experience in specialty practices (e.g., radiology, surgery, cardiology, orthopedics)</li><li>Certification such as CPC, CPB, or equivalent</li><li>Knowledge of denial management and appeals processes</li></ul>Skills &amp; Competencies<ul><li>Analytical and problem-solving abilities</li><li>Ability to multitask in a fast-paced environment</li><li>Strong follow-up and time-management skills</li><li>Team-oriented with the ability to work independently</li><li>Professional and patient-focused communication style</li></ul>Job Type: Full-timePay: Rs50,000.00 - Rs80,000.00 per monthApplication Question(s):<ul><li>Will you be able to work in night shift(7pm to 4am)?</li><li>Will you be able to commute to Bahria Town Phase 7 Rawalpindi?</li></ul>Work Location: In person

Authorization Specialist in Medical Billing

Value Engineering

Backend Developer Experience: 5+ Years Location: Onsite Employment Type: Full-time Job DescriptionWe are looking for a skilled Backend Developer with 5+ years of experience in designing, developing, and maintaining scalable server-side applications. The ideal candidate has strong problem-solving skills, a solid understanding of backend architecture, and hands-on experience with APIs, databases, and cloud-based systems.Key Responsibilities Design, develop, and maintain robust backend services and APIs Build scalable and secure RESTful and/or GraphQL APIs Implement business logic and data processing workflows Integrate backend systems with front-end applications and third-party services Optimize applications for performance, reliability, and scalability Design and manage databases, including schema design and query optimization Ensure application security, data protection, and compliance best practices Write clean, maintainable, and well-documented code Participate in code reviews and follow backend development best practices Debug, troubleshoot, and resolve production issues Collaborate with frontend developers, product managers, and DevOps teamsRequired Skills &amp; Qualifications 5+ years of experience in backend development Strong proficiency in Node.js (Express/NestJS) or Python (Django/FastAPI) Experience building and consuming RESTful APIs (GraphQL is a plus) Solid understanding of databases (PostgreSQL, MySQL, MongoDB, etc.) Knowledge of authentication and authorization mechanisms (JWT, OAuth, RBAC) Experience with version control systems like Git Familiarity with asynchronous processing, queues, and background jobs Strong understanding of application security and performance optimizationJob Type: Full-timeWork Location: In person

Backend Developer

BLS Solutions

The Eligibility Verification Executive is responsible for making outbound fresh follow-up calls to insurance companies and patients to verify coverage, benefits, and claim status for medical billing. The role ensures accurate and timely confirmation of eligibility to support clean claim submission and reduce denials.Key Responsibilities:Make outbound fresh calls to insurance payers to verify patient eligibility and benefits.Confirm:<ul><li>Active coverage</li><li>Policy effective dates</li><li>Co-pay, co-insurance, and deductible</li><li>Plan limitations and exclusions</li><li>Referral and authorization requirements</li><li>Check claim status for submitted medical bills.</li><li>Update eligibility and verification of details in the billing system.</li><li>Document call reference numbers and payer responses accurately.</li></ul>Identify and report:<ul><li>Inactive policies</li><li>Incorrect member information</li><li>Coverage terminations</li><li>Coordinate with the medical billing and AR team for claim corrections.</li><li>Maintain daily productivity and quality targets.</li><li>Follow HIPAA and data confidentiality guidelines.</li><li>Required Skills</li><li>Good communication and listening skills</li><li>Basic knowledge of medical billing and insurance terminology</li><li>Ability to handle payer portals and call workflows</li><li>Strong attention to detail</li><li>Time management and target-oriented work approach</li><li>Basic computer skills (EHR/Practice Management System, MS Excel)</li><li>Preferred Qualifications</li><li>Bachelor&rsquo;s degree (or equivalent)</li></ul>Fresh:<ul><li>Medical billing</li><li>Eligibility verification</li><li>AR follow-up</li><li>Knowledge of CPT, ICD-10, and HCPCS codes (preferred but not mandatory for fresh candidates)</li><li>Key Performance Indicators (KPIs)</li><li>Number of calls completed per day</li><li>Accuracy of eligibility verification</li><li>Documentation quality</li><li>Reduction in eligibility-related claim denials</li></ul>Job Type: Full-timePay: From Rs50,000.00 per monthWork Location: In person

Medical Billing Follow-up Executive / Eligibility Verification Intern

Comtanix

Company OverviewComtanix is an IT services company providing digital solutions for clients in various industries. We focus on delivering efficient, reliable, and process-driven services to support business growth.Open Positions<ul><li>Accounts Officer</li><li>Finance Officer</li><li>Inside Sales Representative</li><li>Business Development Representative</li><li>Outbound Sales Representative</li><li>E-commerce Sales Representative</li><li>Vendor Relations Specialist</li><li>E-commerce Listing Specialist</li><li>Marketing Team Lead</li><li>Customer Support Representative</li></ul>Eligibility Requirements<ul><li>Bachelor&rsquo;s degree (required)</li><li>Strong English communication skills (spoken &amp; written)</li><li>Basic computer proficiency</li><li>Fresh graduates and experienced candidates may apply</li><li>Willingness to work the night shift</li></ul>Work LocationPlaza No. 610, Noor Heights (2nd Floor) Central Business District South Bahria Town Phase 8, RawalpindiInterview InformationInterviews are scheduled Tuesday to Thursday, 8:00 PM &ndash; 10:00 PMRequired Documents<ul><li>Updated resume (hard copy)</li><li>Copy of CNIC</li></ul>Benefits<ul><li>Professional work environment</li><li>Learning and growth opportunities</li><li>Fixed working hours</li><li>Competitive salary aligned with market standards</li><li>Health</li><li>Health benefits as per company policy</li></ul>Job Type: Full-timePay: Rs40,000.00 - Rs80,000.00 per monthApplication Question(s):<ul><li>Are you comfortable working from our office in Bahria Town Phase 8, Rawalpindi?</li><li>Would you be comfortable working the night shift?</li></ul>Work Location: In person

Multiple Night Office Roles – Comtanix

Gamican pvt ltd

Job Title: Junior SEO SpecialistCompany: Gamican (Pvt.)LtdJob Summary: Gamican is seeking a proactive and creative Junior SEO Specialist to join our dynamic team. In this role, you will assist in optimizing our website for search engines, create compelling content, and manage our social media presence. Your work will directly contribute to driving organic traffic, improving search engine rankings, and enhancing Gamican's online presence.<ul><li>Key Responsibilities:</li></ul>Conduct keyword research, competitor analysis, and optimize website content for SEO. Create SEO-friendly content, including blog posts and web copy. Plan and execute social media strategies to enhance engagement. Monitor performance using tools like Google Analytics and SEMrush. Stay updated on SEO trends and best practices.<ul><li>Qualifications:</li></ul>1 year to 2 year of experience in SEO and content creation. Familiarity with tools like Google Analytics, SEMrush, or Moz. Basic knowledge of HTML and web design principles (preferred). Strong writing, communication, and creativity skills.<ul><li>What We Offer:</li></ul>A collaborative and innovative work environment. Opportunities for growth and learning. Exposure to exciting projects with real impact.Job Type: Full-timePay: Rs30,000.00 - Rs40,000.00 per monthWork Location: In person

Junior SEO

PMTAC Pvt Ltd

Job Title: SNF Medicare Billing Specialist &ndash; PDPM (Skilled Nursing Facility)Location: Rawalpindi, Pakistan (Onsite) Company: PMTAC Pvt. Ltd. Shift: Night Shift (US Healthcare)Position OverviewPMTAC is seeking an experienced SNF Medicare Billing Specialist with strong knowledge of the Patient-Driven Payment Model (PDPM) and Skilled Nursing Facility (SNF) Medicare Part A billing requirements. The ideal candidate will have hands-on experience with MDS-driven reimbursement, HIPPS coding, and UB-04 claim submission.This role requires a strong understanding of Centers for Medicare &amp; Medicaid Services (CMS) billing guidelines and compliance regulations.Key Responsibilities1. Medicare Eligibility Verification<ul><li>Verify Medicare Part A coverage for SNF residents.</li><li>Confirm qualifying 3-day hospital stay and benefit period.</li><li>Review secondary insurance coverage (Medicaid, Medicare Advantage, commercial payers).</li></ul>2. MDS &amp; PDPM Coordination<ul><li>Review and ensure accurate completion of Minimum Data Set (MDS) assessments.</li><li>Validate:</li><li>Clinical conditions</li><li>Functional status</li><li>Comorbidities</li><li>Confirm HIPPS code generation from MDS.</li><li>Ensure documentation supports PDPM classification.</li><li>Understand and apply the guidelines of the Patient-Driven Payment Model.</li></ul>3. UB-04 (CMS-1450) Claim Preparation<ul><li>Prepare and submit facility claims using the UB-04 (CMS-1450) form.</li><li>Accurately complete required fields including:</li><li>Type of Bill (21X)</li><li>Statement Covers Period</li><li>Revenue Codes (0022&ndash;0029 for PDPM)</li><li>HIPPS Code</li><li>Units (covered days)</li><li>Total Charges</li><li>Occurrence Codes (qualifying hospital stay)</li><li>Ensure proper reporting of PDPM per diem billing structure.</li></ul>4. Claim Submission &amp; Follow-Up<ul><li>Submit claims electronically via EDI/clearinghouse or CMS DDE.</li><li>Work with Medicare Administrative Contractors (MACs).</li><li>Monitor claim status and resolve denials or RTPs.</li><li>Submit corrected claims when MDS or HIPPS codes change.</li></ul>5. Payment Reconciliation &amp; Post-Processing<ul><li>Post Medicare payments and reconcile PDPM variable per diem rates.</li><li>Identify underpayments or discrepancies.</li><li>Coordinate professional claims (CMS-1500) separately from facility billing.</li></ul>6. Compliance &amp; Audit Readiness<ul><li>Ensure clinical documentation supports billed services.</li><li>Maintain compliance with CMS and Medicare billing regulations.</li><li>Assist with audits and ADR responses.</li></ul>Required Qualifications<ul><li>Minimum 2&ndash;3 years of SNF Medicare Part A billing experience.</li><li>Strong knowledge of PDPM reimbursement methodology.</li><li>Experience working with MDS assessments and HIPPS coding.</li><li>Proficiency in UB-04 (CMS-1450) claim preparation.</li><li>Understanding of revenue codes 0022&ndash;0029.</li><li>Familiarity with Medicare Administrative Contractors (MACs).</li><li>Experience with electronic billing systems and clearinghouses.</li><li>Strong attention to detail and regulatory compliance knowledge.</li></ul>Preferred Qualifications<ul><li>RHIT, RHIA, CPC, or CPB certification.</li><li>Experience in long-term care or post-acute care settings.</li><li>Knowledge of Medicare Advantage SNF billing.</li></ul>Core Competencies<ul><li>Knowledge of PDPM case-mix components (PT, OT, SLP, Nursing, NTA).</li><li>Understanding of variable per diem adjustments.</li><li>Ability to analyze MDS-driven reimbursement.</li><li>Strong denial management skills.</li><li>Excellent documentation review and audit readiness skills.</li></ul>Interested candidates with SNF Medicare Billing Specialist are encouraged to apply by sharing their CV at: careers@pmtac.coma.arslan@pmtac.com Subject: SNF Medicare Billing SpecialistJob Type: Full-timePay: Rs80,000.00 - Rs150,000.00 per monthExperience:<ul><li>SNF Medicare PDPM billing: 2 years (Required)</li><li>MDS assessments and HIPPS coding: 2 years (Required)</li><li>UB-04 (CMS-1450) claim preparation: 2 years (Required)</li></ul>License/Certification:<ul><li>RHIT, RHIA, CPC, or CPB certification (Required)</li></ul>Location:<ul><li>Rawalpindi (Required)</li></ul>Work Location: In person

SNF Medicare Billing Specialist – PDPM (Skilled Nursing Facility)

Cloud Rexpo Pvt. Ltd.

Bahria Town Phase 7, Rawalpindi (On-site) Shift: 9:00 PM &ndash; 6:00 PMWe are seeking an experienced and highly motivated Full-Stack Software Developer with strong expertise in React.js, Node.js, and AWS cloud infrastructure. The ideal candidate will be responsible for designing, developing, deploying, and maintaining scalable web applications and SaaS platforms.This role requires hands-on development capability, system architecture understanding, and experience managing cloud-based production environments.Key Responsibilities<ul><li>Design, develop, and maintain full-stack web applications using React.js and Node.js.</li><li>Build scalable RESTful APIs and backend services.</li><li>Architect and manage AWS cloud infrastructure (EC2, S3, RDS, Lambda, etc.).</li><li>Develop secure authentication and authorization systems (JWT, OAuth).</li><li>Optimize applications for performance, scalability, and security.</li><li>Implement CI/CD pipelines and manage deployment processes.</li><li>Write clean, maintainable, and well-documented code.</li><li>Troubleshoot production issues and ensure system reliability.</li><li>Collaborate with product managers, UI/UX designers, and DevOps teams.</li><li>Participate in code reviews and technical planning sessions.</li></ul>Technical RequirementsFrontend<ul><li>Strong command of React.js</li><li>Redux / Context API</li><li>Modern JavaScript (ES6+)</li><li>HTML5, CSS3</li><li>Responsive and cross-browser development</li></ul>Backend<ul><li>Node.js with Express.js</li><li>REST API development</li><li>Database design and management (MongoDB, PostgreSQL, or MySQL)</li><li>Data modeling and performance optimization</li></ul>Cloud &amp; DevOps<ul><li>Hands-on experience with AWS (EC2, S3, RDS, Lambda, CloudWatch)</li><li>Deployment and infrastructure management</li><li>CI/CD implementation</li><li>Git version control</li><li>Docker (preferred)</li></ul>Required Qualifications<ul><li>2&ndash;5+ years of professional full-stack development experience</li><li>Experience building SaaS or enterprise-grade applications</li><li>Strong understanding of system architecture and scalable design</li><li>Experience working in production environments</li><li>Ability to work independently and meet deadlines</li><li>Strong analytical and problem-solving skills</li></ul>Preferred Qualifications<ul><li>AWS architecture or DevOps experience</li><li>Experience in SaaS or PropTech domain</li><li>Exposure to international clients or startups</li><li>Knowledge of microservices architecture</li></ul>Job Type: Full-timePay: Up to Rs150,000.00 per monthExperience:<ul><li>Full-Stack Development: 3 years (Required)</li><li>SaaS or enterprise-grade: 3 years (Required)</li><li>Frontend, Backend and Cloud &amp; DevOps: 3 years (Required)</li></ul>Location:<ul><li>Rawalpindi (Required)</li></ul>Work Location: In person

Full-Stack Software Developer (React.js + Node.js + AWS) (Night Shift)

Explore 28+ Authorization specialist in Medical Billing Jobs In Medical Billing Jobs In Medical Billing Jobs In Rawalpindi this March. Find roles across top companies and apply now to boost your career.