authorization specialist

Physicians Revenue Group

Job Type: Full-Time | Onsite Shift Timing: Night Shift (06:00 PM &ndash; 03:00 AM) Weekly Off: Saturday &amp; Sunday Location: LahoreJob OverviewWe are seeking an experienced Authorization Specialist to join our US healthcare operations team. The ideal candidate will have hands-on experience in prior authorization processes within the US healthcare system and a strong understanding of Revenue Cycle Management (RCM). This role requires excellent communication skills, attention to detail, and the ability to independently manage authorization workflows.Key Responsibilities<ul><li>Handle end-to-end prior authorization processes for medical procedures, medications, and services</li><li>Verify patient insurance eligibility, coverage, and benefits</li><li>Submit authorization requests via insurance portals, fax, and outbound calls</li><li>Follow up with insurance companies to ensure timely approvals</li><li>Review and interpret payer guidelines for authorization requirements</li><li>Maintain accurate documentation and authorization records in the system</li><li>Coordinate with billing, coding, and clinical teams to resolve authorization-related issues</li><li>Manage denials related to authorization and initiate re-submissions or appeals when required</li><li>Track and report authorization status using MS Excel or internal systems</li><li>Communicate professionally with insurance representatives and internal stakeholders</li></ul>Eligibility &amp; Requirements<ul><li>Qualification: Bachelor&rsquo;s degree (required)</li><li>Experience: Minimum 1&ndash;3 years of experience in prior authorization / RCM (US Healthcare)</li><li>Strong command of English (spoken &amp; written)</li><li>Hands-on experience with insurance portals and authorization workflows</li><li>Proficiency in MS Excel (tracking, reporting, basic formulas)</li><li>Experience in handling calls with insurance companies</li><li>Must be a permanent resident of Lahore</li><li>Willingness to work night shift (US shift)</li></ul>Skills Required<ul><li>Strong communication and interpersonal skills</li><li>In-depth understanding of prior authorization processes</li><li>Analytical and problem-solving skills</li><li>High attention to detail and accuracy</li><li>Ability to manage workload independently and meet deadlines</li><li>Team-oriented with a professional attitude</li></ul>Why Join Us<ul><li>Fixed night shift with weekends off</li><li>Competitive salary based on experience</li><li>Growth opportunities in US healthcare and RCM</li><li>Structured processes and supportive work environment</li><li>Long-term career progression in medical billing</li></ul>Job Type: Full-timeAbility to commute/relocate:<ul><li>Lahore: Reliably commute or planning to relocate before starting work (Preferred)</li></ul>Education:<ul><li>Bachelor's (Preferred)</li></ul>Experience:<ul><li>Authorization Specialist: 2 years (Preferred)</li></ul>Work Location: In person

Authorization Specialist

Integral Care-Austin, TX

<div>
 
 Job Number:
 
 26-11098
 
 
 
 Job Summary:
 
 The Authorization Specialist is responsible for daily oversight of authorization request and approvals requiring interface with internal and external persons/entities and any other activities related to reimbursement for services of Crisis residential/respite programs. Performs regular updates and verification of insurance coverage. Other regular work duties may also involve meeting and greeting clients, facilitating client information, requesting payment for services rendered, handling various types of payments, issuing receipts for payment, retrieving message off facility voicemail, provide continuity of care email info for court related collaborators, building schedules in the Electronic Health Record for the providers, scanning client docs, supplies inventory/ordering/stocking, submission of work order requests, etc. and other duties as requested/assigned. This position provides a variety of moderately complex clerical work in support of the unit operations. Assignments involve difficult and responsible work in office, business, or fiscal operations with moderate latitude for the use of initiative and independent judgment. The Authorization Specialist works under the direct supervision of the unit Practice Manager and in collaboration with the multi-disciplinary team to help meet and assist clients' needs.
 
 
 Regular, predictable attendance is considered to be an essential requirement for this position. Other duties may be assigned. May require a flexible work schedule.
 
 
 Integral Care employees are to strive to maintain a trauma sensitive workplace, to embrace trauma sensitive and informed practices, and to foster a supportive and welcoming environment of care.
 
 
 
 Education
 
 
 
 Required:
 
 
 <ul>
 <li>
 High School Diploma or GED equivalent required.
 
 
 </li>
 </ul>
 
 License
 
 
 
 Required:
 
 
 <ul>
 <li>
 Current and valid driver's license and a clean driving record.
 
 
 </li>
 </ul>
 
 Hours:
 
 Full-Time.
 
 
 
 Workdays:
 
 Monday - Friday.
 
 
 
 Workhours:
 
 8:00AM - 5:00PM.
 
 
 
 Salary:
 
 $23.02 an hour plus an additional 10% crisis stipend.
 
 
 
 Why join us:
 
 Integral Care has proudly served Travis County residents for the past 50 years. As the largest provider of behavioral health services in Travis County, we are dedicated to improving the lives of adults and children living with mental illness, substance use disorder, and intellectual and developmental disabilities.
 
 
 By joining our team, you will find rewarding work every day alongside people who have as much compassion as you. Join us and together we can help improve the quality of life for the people we serve. Imagine your career at Integral Care!
 
 
 
 Employee Benefits
 
 
 
 <ul>
 <li>
 Medical, Dental, and Vision insurance
 </li>
 <li>
 Generous vacation/holiday/sick leave
 </li>
 <li>
 Life and Short-term/Long-term Disability Insurance
 </li>
 <li>
 Employee Assistance Program (EAP)
 </li>
 <li>
 403(b) retirement account
 </li>
 <li>
 Gold's Gym membership discount
 </li>
 <li>
 Mileage reimbursement
 
 
 </li>
 </ul>
 All qualified applicants will receive consideration for employment without regard to race, creed, color, religion, national origin, sexual orientation, gender identity, disability, veteran status, sex or age.
 
 
 For specific positions, additional compensation may be offered to candidates who are bilingual in English and another language deemed necessary for the role.
</div>

Veins OC

Job Overview We are seeking a proactive and detail-oriented Prior Authorization Specialist to join our healthcare team. In this vital role, you will be responsible for managing the authorization process for medical varicose vein clinic, ensuring timely approvals that facilitate seamless patient care. Your expertise in managed care policies, medical terminology, and insurance procedures will drive efficiency and accuracy in processing prior authorizations. This position offers an exciting opportunity to contribute to a dynamic healthcare environment where your skills directly impact patient outcomes and provider satisfaction.Responsibilities<ul><li>Review and evaluate prior authorization requests for varicose vein treatments, ensuring all documentation complies with insurance requirements and clinical guidelines</li><li>Communicate effectively with healthcare providers, insurance companies, and patients to gather necessary information and clarify authorization statuses</li><li>Verify insurance coverage, eligibility, and benefits using insurance verification tools and systems</li><li>Maintain detailed records of authorization requests, approvals, denials, and related correspondence in accordance with HIPAA regulations</li><li>Utilize CPT coding, ICD-9, ICD-10, and ICD coding standards to accurately document procedures and diagnoses for authorization purposes</li><li>Collaborate with medical office staff to facilitate smooth workflow and timely processing of authorizations</li><li>Stay updated on managed care policies, insurance plan changes, and coding updates to ensure compliance and accuracy</li></ul>Requirements<ul><li>Proven experience in managed care environments or medical office settings with a focus on prior authorizations</li><li>Strong knowledge of medical terminology, medical records management, and medical coding including CPT, ICD-9, ICD-10 codes</li><li>Familiarity with HIPAA regulations to ensure patient confidentiality and data security</li><li>Experience with insurance verification processes within healthcare VARICOSE VEIN TREATMENT AUTHORIZATONS SUCH AS ABLATION, VARITHENA AND SCLEROTHERAPY PROCEDURES</li><li>Excellent communication skills for liaising between providers, insurers, and patients</li><li>Office experience with proficiency in electronic health records (EHR) systems or similar software</li><li>Knowledge of medical billing procedures and familiarity with medical records management is a plus</li></ul>Join us to be part of a dedicated team committed to delivering exceptional patient care through efficient authorization processes. Your expertise will help streamline operations while supporting the health and well-being of our patients.Pay: $25.00 - $29.00 per hourWork Location: In person

Prior Authorization Specialist

ATI Physical Therapy

<div><div>The Authorization Specialist is responsible for obtaining authorizations for our patients by providing the appropriate forms and clinical data to insurance companies. This role works with Revenue Cycle staff members and Clinicians to coordinate the authorization process in a timely and accurate manner for various carriers.</div><div></div><div> 
This is a hybrid role that includes working on-site for initial training period and quarterly staff meetings.</div><ul><li> 
Develop relationships with Nurse Case Managers/Adjusters to provide top notch customer service experience.</li><li>Verify and obtain authorizations as required by insurance companies dependent upon the plan coverage for all patients.</li><li>Accurately enter authorized dates, visit or units into ATI&rsquo;s Electronic Medical Records (EMR) to correctly track therapy services.</li><li>Coordinate efforts and communication between the insurance companies and the clinic regarding insurance specific forms and timelines so that the patient is authorized throughout any continued care that is needed.</li><li>Provide feedback for authorization changes according to insurance plan changes.</li><li>Collaborate with the Central Billing Office for missed authorizations while the patient was being seen for therapy service.</li><li>Efficiently handle the assigned authorization workload to assure timely completion of requests.</li><li>Ensure compliance to departmental and company policies and procedures.</li><li>Complete all assigned training programs.</li><li>Collaborate with team members with supportive communication, respect, and appropriate feedback.</li></ul><div> 
Minimum Education 
Required: 
<ul><li>High School diploma</li></ul></div><div></div><div> 
Minimum Experience 
Required: 
<ul><li>1 year of Healthcare or Health Insurance experience.</li></ul></div><div></div><div> 
Knowledge, Skills, and Abilities 
<ul><li>Strong organization skills to initiate and follow-up on authorizations.</li><li>Attention to detail.</li><li>Ability to multitask.</li><li>Ability to collaborate with internal and external teams.</li><li>Ability to provide clear direction through written and verbal communication.</li><li>Strong customer orientation.</li><li>Excellent interpersonal and communication skills.</li><li>Proficient in Microsoft Office (Word, PowerPoint, Excel).</li></ul></div></div>

MSA Authorization Specialist

Top Line Resource Group (TLRG)

Location: DHA Phase 8, Lahore [Onsite]Employment Type: Full-timeWork Timing: 05 PM &ndash; 02 AM Pakistan Time (US Business Hours)Job OverviewTopline Resource Group (TLRG) is seeking a dedicated Eligibility &amp; Authorization Specialist to manage the critical front-end operations for our US-based healthcare clients. This role is focused entirely on securing the financial foundation of the practice by ensuring every patient has active coverage and every procedure has the required clinical approval before services are rendered.Key Responsibilities<ul><li>Verify patients' insurance coverage and eligibility in real-time to ensure policies are active and services are covered on the specific Date of Service (DOS).</li><li>Obtain pre-authorizations from insurance companies for medical procedures and treatments.</li><li>Communicate directly with patients regarding their insurance status, coverage specifics, and any required actions or out-of-pocket responsibilities.</li><li>Maintain accurate and meticulous records of insurance verifications and authorizations, including representative names and unique reference numbers for audit trails.</li><li>Collaborate with healthcare providers to ensure all necessary clinical information, physician notes, and CPT/ICD-10 codes are obtained for successful pre-authorizations.</li><li>Monitor and follow up on pending authorizations daily to ensure timely processing and stay within the 7&ndash;10 day payer response window.</li><li>Analyze insurance benefits to identify exact copays, unmet deductibles, and co-insurance percentages to ensure accurate front-end collections.</li><li>Identify if the provider is in-network or out-of-network and determine if specific plan tiers (HMO/EPO) require a PCP referral before the visit.</li><li>Stay up to date with insurance policies, CMS regulations, and HIPAA guidelines to ensure 100% compliance across all US healthcare accounts.</li><li>Track and manage KPIs, including the clean claim rate and authorization turnaround time, to reduce AR aging and increase collection rates.</li></ul>Required Qualifications<ul><li>3+ years of experience in US Medical Billing, specifically focused on Front-End operations (Eligibility and Authorizations).</li><li>Expert-level familiarity with CPT, ICD-10, and HCPCS codes and their specific relationship to authorization requirements.</li><li>Deep understanding of US insurance plans, including Medicare, Medicaid, HMO, PPO, and Commercial plans.</li><li>Hands-on experience with EHR/EMR systems, Practice Management software, and major US payer portals (Availity, Navinet, etc.).</li><li>Excellent verbal and written English communication skills for professional interaction with US insurance companies and clinical teams.</li><li>Strong analytical ability to interpret Verification of Benefits (VOB) reports and payer medical necessity criteria to resolve issues before service delivery.</li></ul>Pay: Rs100,000.00 - Rs125,000.00 per monthExperience:<ul><li>eligibility &amp; authorization: 2 years (Required)</li></ul>Work Location: In person

Eligibility & Authorization Specialist

Prima Systems

POSITION SUMMARY: The RCC Authorization Coordinator's primary responsibility is to perform stationary, telephonic communication for authorization of rehab services for managed care and insurance customers, with the goal to capture reimbursable managed care and commercial insurance revenue associated with outpatient services, in a timely and accurate manner to maximize timely billing. This position involves a variety of assignments requiring confidentiality and familiarity with the operating details of the overall company.RESPONSIBILITIES/ACCOUNTABILITIES: Authorization: 1. Provide professional support to Rehab Services Operations personnel by obtaining all authorizations on all outpatient managed care and commercial insurance customers in accordance with HIPAA regulations in handling patient confidential information.2. Understand each managed care and commercial insurance plan&rsquo;s authorization/referral process and medical necessity requirements. Update quarterly or as necessary.3. Maintain an ongoing tracking log of all referrals&rsquo; open authorizations/re‐authorizations by facility by plan.4. Navigate insurance plan portals to understand benefit data and patient specific information (primary care physician, etc.) and generate referrals and authorizations if necessary.5. Communicate regularly and consistently concerning any patient or plan updates, via e‐mail and telephone, to rehabilitation and/or facility representatives.6. Maintain and verifies accuracy of records of correspondence, reports, and related matters.7. Assist in compiling and distributing activity reports to supervisor.a. Utilize proprietary software systems, e.g. ROX, etc., in order to accomplish all day‐to‐day tasks, and create the related electronic documentation in order to ensure access toinformation for all concerned.8. Educate new rehabilitation and facility staff as necessary concerning the authorization process and the role of the RCC Authorization Coordinator.9. Work with Managed Care Billing and Rehab Service personnel on billing/collection issues as required to accomplish payment for outpatient services authorized and rendered.Administrative Support: a. Answer and screen phone calls and/or emails.b. Type reports, memos, letters, etc. which often involves matters of a confidential andtechnical nature.c. Prepare and maintain files of correspondence reports and related matters.d. Assist in compiling and distributing all standardized departmental reports.3. Performs other related duties as required.SPECIFIC EDUCATIONAL/VOCATIONAL REQUIREMENTS: 1. High school diploma or related experience is required for this position.2. Familiarity with insurance terminology is preferred.JOB SKILLS: 1. Strong organizational skills and excellent verbal and written skills.2. Ability to successfully multi‐task under pressure and in stressful situations while maintaining professionalism at all times intact and poise.3. Demonstrates good judgment and initiative in selecting the most effective work methods and tools and be able to prioritize your work.4. Must have the ability to exercise administrative judgment within general guidelines.5. Must possess the ability to positively interact with employees at all levels of the organization and the general public.6. Demonstrates intermediate skills with Microsoft Office, especially with Outlook, Excel and Power Point. Comfortable learning and using proprietary business software applications.7. Must have the ability to accomplish rapid computer data entry.8. Superior internal and external customer service skills.PERFORMS RELATED DUTIES: 1. The RCC Authorization Coordinator interacts with Corporate, Area and center‐based staff on a variety of professional levels.2. S/he carries out other tasks as requested in situations where additional support may be requiredJob Type: Full-timePay: Rs80,000.00 - Rs90,000.00 per monthExperience:<ul><li>authorization: 2 years (Preferred)</li></ul>Language:<ul><li>English (Preferred)</li></ul>Location:<ul><li>Lahore (Preferred)</li></ul>Work Location: In person

Signature Performance

<div><div>Position Purpose:

This position is responsible for working closely with Patient, Patient Access, Payers, and Providers' office to validate insurance plans, eligibility, and orders to procure required prior authorizations.

Organization:

This position reports to the Revenue Cycle Manager.

Essential Job Functions include the following. Other duties may be assigned.
<ul>
<li>Collaborate with insurers to obtain pre-authorizations for condition-specific medications, diagnostic procedures and treatments, and support patients in navigating barriers / coverage and disputes.</li>
<li>Submit prior authorization requests for medical procedures, diagnostic tests, treatments, and medications as required by insurance providers.</li>
<li>Gather, review, and submit all necessary clinical documentation to support authorization requests, ensuring accuracy and completeness.</li>
<li>Communicate with insurance representatives to clarify requirements, resolve authorization denials, and follow up on pending approvals.</li>
<li>Collaborate with physicians, nurses, and other clinical staff to obtain additional clinical information or documentation required by insurance companies.</li>
<li>Inform patients about the status of their authorization requests, answer questions regarding coverage, and provide guidance on next steps.</li>
<li>Maintain accurate and detailed records of all prior authorization requests, outcomes, and patient information in compliance with HIPAA regulations.</li>
<li>Stay updated on changes in insurance policies, state and federal regulations, and organizational policies affecting prior authorizations and reimbursement.</li>
<li>Meet quality and productivity standards set by Signature and/or our client.</li>
<li>Provide excellent customer service in keeping with Signature's legacy both internal and externally.</li>
<li>Maintain expertise in multiple current client systems.</li>
<li>Maintain up to date knowledge of revenue cycle management, industry trends perform other duties as necessary.</li>
<li>Acts as an effective team member.</li>
</ul>
Required Knowledge &amp; Experience:
<ul>
<li>Minimum 2 years of prior authorization experience, insurance coordination, or case management within a physician office, hospital, or insurance plan authorizations unit.</li>
<li>Understanding of healthcare insurance systems</li>
<li>Strong written and verbal communication skills with the ability to explain complex medical and insurance information</li>
<li>Strong attention to detail</li>
<li>Passion for patient advocacy with a problem-solving mindset, focusing on overcoming challenges to accessing care.</li>
<li>Ability to work effectively both independently and as part of a multidisciplinary team</li>
<li>Computer proficiency including Microsoft Office, Word, Excel and Outlook</li>
<li>Ability to function effectively in a fast-paced environment.</li>
<li>Personal traits of a high-level commitment, motivation, energy, team orientation, professionalism, trust, personal honesty and integrity, and a demonstration of placing others in a place of high value.</li>
</ul>
Preferred Knowledge &amp; Experience:
<ul>
<li>Preferred experience and understanding of medical terminology</li>
<li>General knowledge of CPT/HCPCS and ICD-10</li>
</ul>
General Areas of Accountability:

Must conduct business and personal affairs in a manner that is always a credit to the company. Must maintain a good credit rating while employed with the company.

The following HIPAA and Privacy items apply to all positions at Signature Performance:
<ul>
<li>Follow HIPAA guidelines for protecting the privacy and security of sensitive personal and/or health information.</li>
<li>Follow Signature expected acceptable use to protect propriety and company owned information.</li>
<li>Complete annually required Privacy and Security Training</li>
</ul>
PERFORMANCE MANAGEMENT:

All Signature Performance associates are subject to regular performance management to determine if skills and training requirements are suitable for the position.

Machines and Equipment:

The incumbent must be able to effectively operate the current computer system, telephone system, and other office machines such as copiers and fax machines.

SECURITY REQUIREMENTS:
<ul>
<li>U.S. Citizenship, naturalized citizenship, or permanent status is required for this position.</li>
<li>All work on all positions at Signature Performance must be completed in the continental United States, Alaska, or Hawaii.</li>
</ul>
Physical Activity:

The incumbent must be able to finger, grasp, feel, see, sit, hear, and speak. This position is sedentary in nature with minimal lifting requirements.

WORKING CONDITIONS:

The incumbent works in an office environment that is not substantially exposed to adverse environmental conditions such as heat, cold, or extreme noise. Routine periods of being on the phone utilizing a headset, sitting and data keying are required.

Remote Eligibility: This position is full-time remote eligible. Eligibility is determined by Management or Talent Operations.

The above statements are intended to describe the general nature of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.
</div>
Requirements:
<div><ul><li>U.S. Citizenship, naturalized citizenship, or permanent status is required for this position.</li>
<li>All work on all positions at Signature Performance must be completed in the continental United States, Alaska, or Hawaii.</li>
</ul>
</div> 
Compensation: $22-$25/hour
 
Additional Details : M-F, either 7am to 330pm or 8am to 430pmCST 
 
Full Time</div>

Search 8253+ Authorization specialist jobs near you this April. New roles added regularly across leading industries. Apply today.

8253 authorization specialist jobs Near Me

Authorization Specialist

Authorization Specialist

Prior Authorization Specialist

MSA Authorization Specialist

Eligibility & Authorization Specialist

Prior Authorization Specialist

Prior Authorization Specialist