Prior Authorization Specialist – Medical Records

About the role

The Prior Authorization Specialist ensures that medical services, procedures, and medications receive timely insurance approvals, preventing claim denials and supporting uninterrupted patient care. Working from our Karachi office, you will collaborate closely with physicians, nurses, and patients to streamline the authorization process.

Key responsibilities

• Review medical records and provider orders to identify authorization requirements.
• Submit prior authorization requests via insurer portals, fax, or phone.
• Track pending authorizations and follow up to secure timely approvals.
• Communicate authorization status to clinicians and patients.
• Document all activities in the billing system or EMR.
• Resolve denials by providing additional clinical documentation.
• Maintain compliance with HIPAA and payer‑specific guidelines.

Required profile

• Bachelor’s degree preferred; healthcare or billing certification a plus.
• 2+ years experience in medical billing, insurance verification, or prior authorization.
• Strong knowledge of CPT, ICD‑10, and HCPCS codes.
• Familiarity with payer portals and insurance processes.
• Excellent communication and organizational abilities.

Required skills

• CPT coding
• ICD‑10 coding
• HCPCS coding
• EMR systems proficiency
• Microsoft Office Suite

What we offer

• Competitive salary and benefits package.
• Professional growth opportunities in healthcare administration.
• Collaborative work environment focused on patient care.