medical authorization specialist

Alogrix

We are looking for a detail-oriented and reliable Medical Billing &amp; Authorization Specialist to join our team. The ideal candidate must have strong English communication skills, good knowledge of medical terminology, and hands-on experience in US medical billing, including verification of benefits (VOB) and prior authorizations.Key Responsibilities:<ul><li>Handle US medical billing processes efficiently</li><li>Perform Verification of Benefits (VOB) with insurance companies</li><li>Obtain and manage prior authorizations</li><li>Review EOBs and claim status</li><li>Follow up on denied or rejected claims</li><li>Communicate with US insurance providers professionally</li><li>Maintain accurate documentation</li></ul>Requirements:<ul><li>Strong English communication skills</li></ul><ul><li>Experience in US medical billing, VOB, and authorizations</li><li>Good understanding of medical terminology</li><li>High attention to detail</li><li>Ability to work in night shift (US hours)</li></ul>How to Apply: WhatsApp : 0328-6940246Email your CV: faisal.billing30@gmail.comJob Type: Full-timePay: Rs40,000.00 - Rs65,000.00 per monthAbility 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>Location:<ul><li>Lahore (Preferred)</li></ul>Work Location: In person

US Medical Billing & Authorization Specialist(Night Shift)

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

The NeuroSpine Group

Company Overview The NeuroSpine Group is dedicated to providing comprehensive neurosurgical spine care within a convenient, patient-centered environment. Our team of specialized surgeons and medical professionals work collaboratively to deliver the highest quality care, ensuring seamless diagnosis, treatment, and recovery for our patients.Job Summary We are seeking an energetic and detail-oriented Prior Authorization Specialist/Scheduling professional to join our dedicated medical team. In this vital role, you will coordinate insurance authorizations, manage scheduling, and ensure smooth communication between patients, providers, and insurance companies. Your proactive approach will help facilitate timely approvals and appointments, contributing to exceptional patient experiences.Duties<ul><li>Obtain prior authorizations from managed care organizations for diagnostic tests, procedures, or treatments</li><li>Verify insurance coverage and benefits for each patient prior to scheduled appointments</li><li>Schedule patient appointments efficiently while coordinating with providers&rsquo; availability</li><li>Maintain accurate medical records, including documentation of authorization requests and approvals</li><li>Communicate clearly with patients regarding scheduling details and insurance requirements</li><li>Ensure compliance with HIPAA regulations to protect patient confidentiality at all times</li><li>Collaborate with medical office staff to streamline office workflows and improve patient service delivery</li></ul>Qualifications<ul><li>Proven experience in medical office administration or scheduling within healthcare settings</li><li>Knowledge of managed care processes, insurance verification, and prior authorization procedures</li><li>Familiarity with medical terminology, CPT coding (Current Procedural Terminology), ICD-9/ICD-10 coding systems, and medical records management</li><li>Strong understanding of HIPAA regulations to ensure confidentiality and privacy standards are met</li><li>Experience working with dental or other specialty offices is a plus</li><li>Excellent organizational skills with attention to detail and ability to multitask effectively</li><li>Prior experience in a fast-paced office environment involving medical coding and insurance processes is highly desirable</li></ul>Join us in making a difference by ensuring our patients receive timely care through efficient scheduling and authorization processes. We value proactive team members who thrive in dynamic healthcare environments!Pay: $22.00 - $29.62 per hourBenefits:<ul><li>Dental insurance</li><li>Health insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Work Location: In person

Prior Authorization Specialist/Scheduling

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

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>

Authorization Specialist

Squad Health

Pay: 130,000.00 (PKR) - 160,000.00 (PKR) per monthPrior Authorization Specialist (Prescription Navigator)Remote | Offshore | Full-Time | EST HoursThree options of working off-hours to choose from:Weekdays | Work Hours: 3:00 AM &ndash; 12:00 PM Pakistan Time (6:00 PM &ndash; 3:00 AM EST)Weekdays | Work Hours: 9:00 AM &ndash; 6:00 PM Pakistan Time (12:00 AM &ndash; 9:00 AM EST)Weekends | Work Hours: 6:00 PM &ndash; 2:00 AM Pakistan Time (9:00 AM &ndash; 5:00 PM EST)Compensation: $450 &ndash; $575 per month Employment Type: Direct Hire | Full-TimeAbout UsSquad Health provides navigation services and software to US medical practices to remove barriers to treatment &mdash; especially prescription access.Our services include benefits investigation, prior authorization submission, patient assistance enrollment, pharmacy coordination, and patient engagement.Our team members operate as extensions of provider offices, supporting clinical staff through accurate documentation and consistent follow-up.Job SummaryWe are seeking an experienced Prior Authorization Specialist with strong background in US specialty medication authorizations. This role requires reviewing clinical documentation, verifying insurance benefits, submitting medication authorizations, and managing denials and appeals efficiently.Duties<ul><li>Verify insurance benefits for drug and procedure orders (Commercial, Medicare, Medicaid)</li><li>Determine pharmacy vs. medical benefit requirements when applicable</li><li>Obtain appropriate authorizations by completing payer-specific forms and clinical questionnaires</li><li>Review medical notes, diagnosis information, and treatment history to answer clinical questions accurately</li><li>Submit and manage authorizations through, payer portals, fax, or phone</li><li>Track pending authorizations and follow up until resolution</li><li>Prioritize and manage STAT/urgent requests appropriately</li><li>Communicate with MDs and NPs regarding denials, treatment plan updates, and Letters of Medical Necessity (LMNs)</li><li>Assist patients with copay assistance or patient assistance programs when needed</li><li>Enroll patients into navigation programs and obtain consent</li><li>Document all actions clearly in internal systems and case trackers</li><li>Participate in team meetings to resolve patient access challenges and improve workflow</li></ul>Required Skills &amp; Experience<ul><li>Minimum 2 years of US-based specialty medication prior authorization experience</li><li>Experience managing other PA Specialists preferred</li><li>Direct experience supporting GI, Dermatology, Rheumatology, and Allergy medication authorizations required</li><li>Strong understanding of US insurance plans (Commercial, Medicare, Medicaid)</li><li>Experience reviewing EMR/EHR clinical documentation</li><li>Strong attention to detail and structured documentation habits</li><li>Fluent English (written and verbal)</li><li>Ability to work without supervision</li></ul>Work Location: RemoteJob Type: Full-timePay: Rs130,000.00 - Rs160,000.00 per monthApplication Question(s):<ul><li>List 5 medications for which you have frequently completed prior authorizations and can discuss during an interview</li><li>Indicate whether you have worked in a hospital, clinic or retail completing medication prior authorizations, and which platforms, portals, EMR systems, you have used?</li><li>Why are you looking to leave (or have already left) your previous employer?</li><li>A summary of your relevant experience in United States-based prescription prior authorizations</li></ul>Work Location: Remote

Prior Authorization Specialist (PK)

Puget Sound Home Health and Hospice

<div>Join Our Team as an Insurance Prior Authorization Specialist at Puget Sound Home Health &amp; Hospice.
Benefits:<ul><li>
$23-28 per hour, DOE</li><li>
Comprehensive Medical, Dental, and Vision insurance</li><li>
Free health concierge services</li><li>
FSA and HSA accounts</li><li>
Paid Life and AD&amp;D insurance</li><li>
Paid Sick, Holidays, and PTO</li><li>
STD, LTD, and other voluntary insurance plans</li><li>
Company-wide celebrations of your great work &amp; accomplishments</li><li>
Support for your professional growth and development</li><li>
Room for advancement</li><li>
AMAZING teammates &amp; leaders who are supportive, inclusive, and fun!</li></ul>
What Do We Require of a Prior Authorization Specialist?
<ul><li>Must have at least 1 year of insurance authorization/billing experience in a medical office, preferably home health/hospice.
</li><li>Experience with Home Care Home Base is strongly preferred</li><li>
Demonstrated cooperation and excellent customer service skills</li><li>
Ability to multi-task and stay on task in a fast-paced office</li><li>
Excellent team-oriented, verbal, and written communication skills</li></ul>
Key Responsibilities:<ul><li>
Verify insurance coverage, including primary and secondary payors</li><li>
Use UGS/DDE and EDS programs to verify Medicare/Medicaid eligibility</li><li>
Obtain visit authorization via payor by providing appropriate medical records</li><li>
Perform accurate data entry in patient records within HCHB</li><li>
Maintain payor files with up-to-date requirements to obtain/initiate appeals for denied authorizations</li><li>
Interface with contract, clinical, and office staff to foster collaboration and positive working relationships</li><li>
Prepare patient co-pay estimates and notify scheduling of authorized visits</li><li>
Provide excellent customer service to patients, referral sources, and community contacts with questions regarding payor prior authorizations and medical guidelines</li><li>
Enter, audit, and follow up on authorized and unauthorized visits within HCHB</li></ul>
Why Puget Sound Home Health &amp; Hospice?
At Puget Sound Home Health &amp; Hospice, we pride ourselves on our quality of care and ethical business practices, guided by our foundational Core Values of CAPLICO:<ul><li>
Customer Second (Employee First!)</li><li>
Accountability</li><li>
Passion for Learning</li><li>
Love One Another</li><li>
Intelligent Risk Taking</li><li>
Celebration</li><li>
Ownership</li></ul>
www.pugetsoundhhh.com<div><div><div><div><div><div><div><div><div><div><div><div><div><div>
The employer for this position is stated in the job posting. The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Each of these businesses is operated by a separate, independent operating subsidiary that has its own management, employees and assets. More information about The Pennant Group, Inc. is available at http://www.pennantgroup.com.</div></div></div></div></div></div></div></div></div></div></div></div></div></div></div>

Prior Authorizations Specialist

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