We are currently seeking an Authorization specialist to join our team. As an Authorization specialist, you will play a vital role in ensuring that all necessary approvals and authorizations are obtained for various processes and activities within the organization.

Responsibilities

  • The Insurance Authorization Specialist is responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process with all commercial payers
  • Review chart documentation to ensure the patient meets medical policy guidelines
  • Prioritize incoming authorization requests according to the urgency
  • Obtain authorization via the payer website or by phone and follow up regularly on pending cases
  • Maintain individual payer files to include up-to-date requirements needed to successfully obtain authorizations
  • Communicates with the ordering physician and/ or APP in the case of denials that will require rescheduling and/or peer-to-peer review by the ordering physician
  • Initiate appeals for denied authorizations
  • Respond to clinic questions regarding payer medical policy guidelines
  • Confirm the accuracy of CPT and ICD-10 diagnoses in the procedure order
  • Contact patients to discuss authorization status

Qualifications

  • Previous experience in pre-authorization/pre-certification and processing of health insurance claims
  • Medical terminology
  • Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively
  • Excellent computer skills including Excel, Word, and Internet use
  • Detail-oriented with above-average organizational skills
  • Plans and prioritizes to meet deadlines
  • Excellent customer service skills; communicates clearly and effectively
  • Ability to multitask and remain focused while managing a high-volume, time-sensitive workload

Schedule 

  • 8 hour shift
  • Night shift
  • Monday to Friday ((6:00 P.M. to 3:00 A.M.)

نوکری کی تفصیلات

کل عہدے:
5 آسامیاں
نوکری کی شفٹ:
تیسرا پہر (رات)
نوکری کی قسم:
نوکری کا مقام:
جنس:
کوئی ترجیح نہیں
کم از کم تعلیم:
انٹرمیڈیٹ / اے لیول
کیریئر کی سطح:
تجربہ کار پیشہ ور
کم از کم تجربہ:
2 سال
اس سے پہلے درخواست دیجیۓ:
جولائی ۰۷, ۲۰۲۳
تاریخِ اِشاعت:
جون ۰۷, ۲۰۲۳
Diversity Inclusion:
We value diversity of our employees. All qualified applicants will receive fair consideration without regard to genders or socio-economic backgrounds.

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صحت کی نگہداشت / ہسپتال / طبی · 51-100 ملازمین - کراچی

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