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Insurance Authorization Specialist

Hubkom Billing Solutions Unverified

Karachi , Pakistan

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Posted Jun 07, 2023 118 views

PKR. 50,000 - 70,000/Month

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.)

Skills

Computer HFO Operations Handling Health Care Knowledge

Job Details

Industry:
Healthcare / Hospital / Medical
Functional Area:
Client Services & Customer Support
Total Positions:
5 Posts
Job Shift:
Third Shift (Night)
Job Type:
Full Time/Permanent
Job Location:
Karachi, Pakistan
Gender:
No Preference
Minimum Education:
Intermediate/A-Level
Career Level:
Experienced Professional
Minimum Experience:
2 Years
Apply Before:
Jul 07, 2023
Posting Date:
Jun 07, 2023
Diversity Inclusion:
We value diversity of our employees. All qualified applicants will receive fair consideration without regard to genders or socio-economic backgrounds.

Hubkom Billing Solutions

Healthcare / Hospital / Medical · 51-100 employees - Karachi
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