authorization specialist

Physicians Revenue Group

<p><b>Job Type:</b> Full-Time | Onsite<br/><b>Shift Timing:</b> Night Shift (06:00 PM &ndash; 03:00 AM)<br/><b>Weekly Off:</b> Saturday &amp; Sunday<br/><b>Location:</b> Lahore</p><p><b>Job Overview</b></p><p>We are seeking an experienced <b>Authorization Specialist</b> 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.</p><p><b>Key Responsibilities</b></p><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><p><b>Eligibility &amp; Requirements</b></p><ul><li><b>Qualification:</b> Bachelor&rsquo;s degree (required)</li><li><b>Experience:</b> 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><p><b>Skills Required</b></p><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><p><b>Why Join Us</b></p><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><p>Job Type: Full-time</p><p>Ability to commute/relocate:</p><ul><li>Lahore: Reliably commute or planning to relocate before starting work (Preferred)</li></ul><p>Education:</p><ul><li>Bachelor's (Preferred)</li></ul><p>Experience:</p><ul><li>Authorization Specialist: 2 years (Preferred)</li></ul><p>Work Location: In person</p>

Authorization Specialist

Integral Care-Austin, TX

<div>
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  Job Number:
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 26-11098
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 <strong>
  Job Summary:
 </strong>
 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.
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 Regular, predictable attendance is considered to be an essential requirement for this position. Other duties may be assigned. May require a flexible work schedule.
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 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.
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 <strong>
  Education
  <br/>
  <br/>
 </strong>
 Required:
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 <br/>
 <ul>
  <li>
   High School Diploma or GED equivalent required.
   <br/>
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  </li>
 </ul>
 <strong>
  License
  <br/>
  <br/>
 </strong>
 Required:
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   Current and valid driver's license and a clean driving record.
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  </li>
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  Hours:
 </strong>
 Full-Time.
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  Workdays:
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 Monday - Friday.
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  Workhours:
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 8:00AM - 5:00PM.
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  Salary:
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 $23.02 an hour plus an additional 10% crisis stipend.
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  Why join us:
 </strong>
 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.
 <br/>
 <br/>
 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!
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  Employee Benefits
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   Medical, Dental, and Vision insurance
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   Generous vacation/holiday/sick leave
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   Life and Short-term/Long-term Disability Insurance
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   Employee Assistance Program (EAP)
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   403(b) retirement account
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   Gold's Gym membership discount
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   Mileage reimbursement
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 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.
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 For specific positions, additional compensation may be offered to candidates who are bilingual in English and another language deemed necessary for the role.
</div>


DeCoach Recovery Centre

<div><div><p><b>Prior Authorization Specialist</b></p><p><b>
Job Description</b></p><div>
DeCoach Recovery is a leading addiction treatment center located in Sharonville, OH, dedicated to providing compassionate care and effective solutions for individuals battling addiction. We are seeking a detail-oriented and experienced Prior Authorization Specialist to join our team.</div><p>
Job Overview: We are seeking a detail-oriented and energetic Prior Authorization Specialist to join our team. In this vital role, you will manage the authorization process for various medical services, ensuring timely approval from insurance providers. Your expertise will help streamline patient care, reduce delays, and enhance overall satisfaction by navigating complex managed care protocols with precision and professionalism.</p><p><b>
Key Responsibilities:</b></p><ul><li>
Review and prepare prior authorization requests for medical procedures, medications, and treatments</li><li>
Verify insurance coverage and eligibility through insurance verification processes</li><li>
Accurately code procedures using CPT (Current Procedural Terminology), ICD-9, ICD-10, and ICD coding systems</li><li>
Maintain comprehensive medical records and documentation in compliance with HIPAA regulations</li><li>
Communicate effectively with healthcare providers, insurance companies, and patients to facilitate authorization approvals</li><li>
Track and follow up on pending authorizations to ensure timely responses</li><li>
Stay current with changes in managed care policies, coding standards, and regulatory requirements</li></ul><p><b>
Qualifications:</b></p><ul><li>
Proven experience in managed care or medical office environments, preferably with prior authorization responsibilities</li><li>
Strong knowledge of medical terminology, medical records management, and medical coding (CPT, ICD-9, ICD-10)</li><li>
Familiarity with insurance verification processes and healthcare billing procedures</li><li>
Experience working in dental or medical offices is highly desirable</li><li>
Excellent organizational skills with attention to detail and accuracy</li><li>
Ability to navigate HIPAA regulations diligently to protect patient confidentiality</li><li>
Office experience demonstrating proficiency with electronic health records (EHR) systems or similar software</li></ul><p><b>
Benefits:</b></p><ul><li>
Competitive salary based on experience.</li><li>
Medical, Dental, &amp; Vision Heath Insurance</li><li>
Company Paid Life Insurance</li><li>
Affiliated with the STAR program, assist employees in paying off student loans</li><li>
Tuition Reimbursement program</li><li>
Paid Time-Off</li><li>
6 paid Holidays off</li><li>
Opportunities for Advancement</li><li>
Yearly Merit Raises</li></ul><p>
Join our dedicated team at DeCoach Recovery and contribute to our mission of providing quality addiction treatment services while ensuring financial sustainability through effective revenue cycle management. If you have the required skills and experience, we encourage you to apply and become part of our compassionate and dynamic team.</p></div><br>
8-4:30</div>

Prior Authorization Specialist

Hazrin

<p><b>Company Description</b></p><p>MedAlign Solutions LLC is a leader in delivering reliable medical billing, coding, and reimbursement solutions tailored for healthcare providers nationwide. Focused on accuracy and efficiency, we streamline the billing process, enabling healthcare professionals to prioritize patient care. Our certified team utilizes advanced technology and industry expertise to ensure timely claims submission, reduce denials, and optimize revenue cycles. With a commitment to personalized support, MedAlign Solutions provides transparent and high-quality services that enhance operational efficiency and help healthcare organizations succeed.</p><p><b>Role Description</b></p><p>This is a full-time on-site role for a Prior Authorization Specialist located in Islamabad. In this position, the specialist will manage and oversee the prior authorization process for medical services by reviewing documentation, verifying patient insurance coverage, coordinating with medical staff, and communicating effectively with insurance companies to ensure approval. Additional responsibilities include maintaining accurate records, resolving authorization issues, and staying updated on changes in insurance policies and procedures to ensure compliance.</p><p><b>Qualifications</b></p><ul><li>Proficiency in handling Prior Authorization, Medical Billing, and Insurance Verification</li><li>Strong organizational and documentation skills to maintain accurate authorization records</li><li>Knowledge of medical terminology, coding, and healthcare regulations</li><li>Effective communication and problem-solving skills for liaising with patients, providers, and insurance companies</li><li>Attention to detail and the ability to manage a high volume of tasks efficiently</li><li>Experience with medical billing software and technology platforms</li><li>Bachelor's degree in healthcare, business, or related field preferred</li><li>Experience in prior authorization or medical billing is highly desirable</li></ul><p>Job Type: Full-time</p><p>Pay: Rs70,000.00 - Rs90,000.00 per month</p><p>Experience:</p><ul><li>Prior Authorization: 1 year (Preferred)</li></ul><p>Location:</p><ul><li>Islamabad (Preferred)</li></ul><p>Work Location: In person</p>

Navani

<div><p><b>Base Pay Range:</b></p><p></p><p><b>
Job Description:</b></p><h2 class="jobSectionHeader"><b>
The Prior Authorization Specialist is a Full Time, Regular position working Monday-Friday 10:30am-7pm CST </b><b>at the Navani Business Center, a wholly owned Inland Imaging company in Arlington, TX.</b></h2><p></p><p><b>
Summary:</b> Prior Authorization Specialists are responsible for assisting patients, referring physicians and their staff in scheduling exams at an Inland Imaging Clinical Associates facility. The Prior Authorization Specialist provides support by processing Insurance verification and ensuring a pre-authorization is in place prior to an exam. The position requires a highly organized, motivated and a skilled problem solver. Attention to detail and strong customer service skills to ensure all necessary steps are taken to accurately identify or process a request for a prior authorization.</p><p></p><p><b>
Essential Duties / Responsibilities:</b> To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p><p></p><ul><li>
Provides high quality customer service by:<ul><li>
Communicates by asking the appropriate questions to get information necessary to verify if an authorization is required and if so enough information to help process the request.</li><li>
Reviews and provides exam specific information as needed to ensure exam and authorization match.</li><li>
Completes phone call with a professional closing</li></ul></li><li>
Determines when an authorization/referral is required</li><li>
Obtains any information necessary to assist with the authorization process<ul><li>
Call patients and/or referring offices on self-pay accounts that may require prior authorization to identify the appropriate insurance.</li></ul></li><li>
Understands the billing process to identify and communicate the codes and forms that may be required to ensure reimbursement.</li><li>
Identifies and communicates any changes, when necessary, in the patient schedule, status (STAT), in-patient add-ons, etc. to appropriate parties</li><li>
Communicates with appropriate person for any follow-up needed on a patient exam.</li><li>
Identifies faxes from prior authorization fax server sent in by referring providers and renames with standard nomenclature</li><li>
Updates patient demographics as needed</li><li>
Adds and verifies patient current insurance information and verifies any changes indicated as part of the insurance look-up process on our internal system. Updates this information when needed.</li><li>
Keeps all on-line web portals accounts active to ensure access is maintained in order to obtain prior-authorization verification.</li><li>
Maintains a working knowledge of supplemental programs (Recondo and Payer websites)</li><li>
Demonstrates appropriate verbal and written communication skills to relay accurate information in a clear, concise manner to peers, staff, management, patients, guests, and medical staff.</li><li>
Initiates appropriate questions and provides timely feedback to lead and management on any issues, policies, and procedures, etc.</li><li>
Organizes and maintains records to provide accurate reporting, easy access to information and historical data.</li><li>
Coordinates patient care between technologists and clerical staff to facilitate a smooth workflow</li></ul><ul><li>
Acts as a liaison between staff, management, and physicians</li><li>
This position may be required to work in a hospital, urgent care or clinical setting.</li><li>
Responsible to be aware of assigned work rotations and monthly assignments</li><li>
Identifies and reports any updates to exam codes and CPT codes to Team Lead that may be encountered when working accounts.</li><li>
Identifies and reports any Payer updates or changes that may be encountered when working accounts to Team Lead.</li><li>
Identifies and reports any changes or updates to Payer web portals used in prior authorization process that may be encountered when working accounts to Team Lead</li><li>
Provides a Bi-weekly or monthly report out of identified issues or concerns regarding payers, system workflow or referring office items.</li><li>
Maintains the prior authorization resource portal by updating referring office contact information.</li><li>
Maintains the prior authorization issue log in smartsheet for tracking payer, billing, referring office or other issues to be reviewed and followed-up on by the Team Leader.</li><li>
Performs other duties as assigned.</li></ul><p><br>
</p><p><b>General Duties/Responsibilities:</b></p><ul><li>
Ability to maintain strict confidentiality within the Inland Imaging companies and Inland&rsquo;s customers.</li><li>
Follows all Health and Safety policies and guidelines of Inland Imaging, Navani or its partners depending on work location.</li><li>
Follows all company policies including those regarding harassment, non-retaliation, discrimination, respectful workplace, and related policies.</li><li>
Follows all policies regarding HIPAA, non-disclosure of confidential information and company security.</li><li>
Honest, pleasant manner and good personal hygiene.</li><li>
Free of alcohol and drug abuse.</li><li>
Valid state driver&rsquo;s license and proof of insurance.</li><li>
Excellent communication and interpersonal skills.</li><li>
Detail oriented; ability to multi-task; organized and able to work in a fast-paced environment.</li><li>
Demonstrates self-directed learning and participation in continuing education through professional journals, approved seminars, etc.</li><li>
Ability to consider individual needs in communication with and assessment and treatment of patients of all ages.</li></ul><ul><li>
Adheres to departmental standards and personnel policies by demonstrating professional demeanor in conduct and appearance.</li><li>
Follows company departmental standards and personnel policies by using good teamwork and communication skills to help identify concerns and solutions, assisting where needed to ensure a smooth functioning department.</li><li>
Performs other duties as required by displaying team spirit and self-growth, accepting and performing other projects and responsibilities, and requesting other projects and responsibilities.</li><li>
Attendance is required for this position.</li><li>
Rotates to other shifts and locations as needed.</li></ul><p></p><p><b>
Supervisory Responsibilities:</b></p><ul><li>
There is no supervisory responsibility in this position</li></ul><p></p><p><b>
Advocacy:</b></p><p>
Treats all patients with dignity and respect Provides excellent customer service Conforms to Joint Commission and HIPAA regulations Complies with PHI (Protected Health Information) Demonstrates the Inland Imaging Core Values</p><ul><li>
Show We Care, Do The Right Thing, Maximize Individual Potential, Challenge Convention</li></ul><p></p><p><b>
Qualifications:
</b></p><ul><li><i>Education: </i>High School Diploma/GED required</li><li><i>
Experience: </i>One year of previous scheduling, insurance or medical office experience required<ul><li>
Proficient and accurate with electronic health systems including applications of billing, pre-authorizations, demographics and coding preferred</li><li>
Anatomy and medical terminology preferred</li><li>
Medical office experience preferred</li><li>
Knowledge of coverage and requirements for private insurances, commercial insurance and government payers. Demonstrated experience using software applications for Electronic Medical Records preferred</li><li>
Understanding of procedures to be read by radiologist preferred</li></ul></li><li><i>
Computer Skills</i>: Experience with the following computer applications is highly desired: Microsoft office products and a strong understanding of internet related access, Workday, Qgenda</li><li><i>
Background Check</i>:<ul><li>
Must be able to pass a background check required by RCW 43.43.830-840 to work with children under the age of 16, developmentally disabled persons or vulnerable adults</li><li>
In order to comply with provisions set forth in Sections 1128 and 1156 of the Social Security Act, all new employees of Navani Health Solutions will be checked against the LIST OF EXCLUDED INDIVIDUALS provided by the Department of Health &amp; Human Services, Office of the Inspector General (OIG). Employees must not be included on this list.</li></ul></li><li><i>
Drug Test</i>: Eligible employees must be able to pass a post-offer, pre-employment drug test including marijuana.</li></ul><p></p><h2 class="jobSectionHeader"><b>
Nuvodia/Inland is an EEO employer...</b></h2></div>

Onco360

<div><div><b>Pharmacy Prior Authorization Specialist &ndash; Onco360 Pharmacy</b><br>
<i>New Hyde Park, NY</i> | <i>Full-Time</i> | <i>Starting at $25.00/hr and up</i></div>
<div></div><div><b>Join a mission-driven team making a difference in the lives of cancer and rare disease patients.</b></div>
<div></div><div>Onco360 Pharmacy is seeking a <b>Pharmacy Prior Authorization Specialist</b> to join our dedicated team in New Hyde Park, NY. This is a full-time position ideal for candidates local to the area. Remote work possible after initial on-site training.</div>
<div> </div><p></p><div><div><b>Why Join Us?</b></div>
<ul><li>A career with purpose: Help patients access life-saving medications.</li>
<li>Supportive culture: We value <b>teamwork, respect, integrity, and passion</b>.</li>
<li>Growth opportunities: We invest in your professional and personal development.</li>
</ul>
</div><div></div><div><b>Company Benefits</b></div>
<ul><li>Medical; Dental; Vision</li>
<li>401k with a match</li>
<li>Paid Time Off and Paid Holidays</li>
<li>Tuition Reimbursement</li>
<li>Quarterly Incentive Bonus</li>
<li>Paid Volunteer Day</li>
<li>Referral Incentive Program</li>
<li>Company Paid Life Insurance; and Short/Long-Term Disability</li>
</ul><p></p><div><b>What You&rsquo;ll Do</b></div>
<div>The Pharmacy Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations from insurance carriers by receiving prescriptions, addressing and rectifying rejected claims and conducting necessary third party authorization requests.</div>
<div></div><div><b>How You&rsquo;ll Do This</b></div>
<ul><li>Manage prior authorization requests and appeals with insurance carriers.</li>
<li>Collaborate with physicians, pharmacists, and other departments.</li>
<li>Ensure HIPAA compliance while handling sensitive patient information.</li>
<li>Maintain accurate documentation of authorization details.</li>
<li>Proactively monitor and renew expiring authorizations.</li>
</ul> <p></p><div><b>What You Bring</b></div>
<div><b>Required:</b></div>
<ul><li>High School Diploma or GED</li>
<li>1+ years of pharmacy or prior authorization experience</li>
<li>Registration with Board of Pharmacy (as required by state law)</li>
<li>Strong communication, organizational, and customer service skills</li>
<li>Self-motivated, organized, detail-oriented, and adaptable to changing priorities</li>
<li>Knowledge of pharmacy terminology, pharmacy insurance claims, Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, experience with CoverMyMeds</li>
</ul><div><b>Preferred:</b></div>
<ul><li>Associate degree or Certified Pharmacy Technician (PTCB)</li>
<li>3+ years of experience in pharmacy or prior authorizations</li>
<li>Specialty pharmacy experience</li>
</ul><p></p><div><b>Ready to make a meaningful impact? Apply today and help us better the lives of those battling cancer.</b></div>
<div></div><div><b>#Company Values: Teamwork, Respect, Integrity, Passion</b></div></div>

Pharmacy Prior Authorization Specialist

<div><div><b>Pharmacy Prior Authorization Specialist &ndash; Onco360 Pharmacy</b><br>
<i>Scottsdale, AZ</i>| <i>Full-Time</i> | <i>Starting at $23.00/hr and up</i></div>
<div></div><div><b>Join a mission-driven team making a difference in the lives of cancer patients.</b></div>
<div></div><div>Onco360 Pharmacy is seeking a <b>Pharmacy Prior Authorization Specialist</b> to join our dedicated team in Scottsdale, AZ. This is a full-time position ideal for candidates local to the area. <b>Remote work possible after initial on-site training.</b></div><br>
<div></div>
 <p></p><div><b>Why Join Us?</b></div>
<ul><li>A career with purpose: Help patients access life-saving medications.</li>
<li>Supportive culture: We value <b>teamwork, respect, integrity, and passion</b>.</li>
<li>Growth opportunities: We invest in your professional and personal development.</li>
</ul><div><b>Company Benefits</b></div>
<ul><li>Medical; Dental; Vision</li>
<li>401k with a match</li>
<li>Paid Time Off and Paid Holidays</li>
<li>Tuition Reimbursement</li>
<li>Quarterly Incentive Bonus</li>
<li>Paid Volunteer Day</li>
<li>Referral Incentive Program</li>
<li>Company Paid Life Insurance; and Short/Long-Term Disability</li>
</ul><p></p><div><b>What You&rsquo;ll Do</b></div>
<div></div><div>The Pharmacy Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations from insurance carriers by receiving prescriptions, addressing and rectifying rejected claims and conducting necessary third party authorization requests.</div>
<div></div><div><b>How You&rsquo;ll Do This</b></div>
<ul><li>Manage prior authorization requests and appeals with insurance carriers.</li>
<li>Collaborate with physicians, pharmacists, and other departments.</li>
<li>Ensure HIPAA compliance while handling sensitive patient information.</li>
<li>Maintain accurate documentation of authorization details.</li>
<li>Proactively monitor and renew expiring authorizations.</li>
</ul> <p></p><div><b>What You Bring</b></div>
<div></div><div><b><i>Required:</i></b></div>
<ul><li>High School Diploma or GED</li>
<li>1+ years of pharmacy or prior authorization experience</li>
<li>Registration with Board of Pharmacy (as required by state law)</li>
<li>Strong communication, organizational, and customer service skills</li>
<li>Self-motivated, organized, detail-oriented, and adaptable to changing priorities</li>
<li>Knowledge of pharmacy terminology, pharmacy insurance claims, Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, experience with CoverMyMeds</li>
</ul><div><b>Preferred:</b></div>
<ul><li>Associate degree or Certified Pharmacy Technician (PTCB)</li>
<li>3+ years of experience in pharmacy or prior authorizations</li>
<li>Specialty pharmacy experience</li>
</ul><p></p><div><b>Ready to make a meaningful impact? Apply today and help us better the lives of those battling cancer.</b></div>
<div></div><div><b>#Company Values: Teamwork, Respect, Integrity, Passion</b></div></div><div></div>

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