Authorization Specialist

We 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.

Handle end-to-end prior authorization processes for medical procedures, medications, and services Verify patient insurance eligibility, coverage, and benefits Submit authorization requests via insurance portals, fax, and outbound calls Follow up with insurance companies to ensure timely approvals Review and interpret payer guidelines for authorization requirements Maintain accurate documentation and authorization records in the system Coordinate with billing, coding, and clinical teams to resolve authorization-related issues Manage denials related to authorization and initiate re-submissions or appeals when required Track and report authorization status using MS Excel or internal systems Communicate professionally with insurance representatives and internal stakeholders

Qualification: Bachelor’s degree (required) Experience: Minimum 1–3 years of experience in prior authorization / RCM (US Healthcare) Strong command of English (spoken & written) Hands-on experience with insurance portals and authorization workflows Proficiency in MS Excel (tracking, reporting, basic formulas) Experience in handling calls with insurance companies Must be a permanent resident of Lahore Willingness to work night shift (US shift)