Authorizations Specialist

Job Title: Authorizations Specialist

Location: South Africa

Job Type: Full-Time, Remote

Working Hours: US Hours (9am-5pm EST)

Salary: South African Rand (ZAR)

Job Overview

As an Authorizations Specialist, you will play a critical role in managing and coordinating prior authorization requests for medical services. You will work closely with healthcare providers, insurance companies, and patients to ensure timely approvals of services, thereby facilitating efficient patient care and billing processes.

Key Responsibilities

• Obtain and process prior authorizations for medical procedures, services, and medications
• Verify insurance eligibility, benefits, and authorization requirements
• Communicate with insurance providers, healthcare offices, and patients regarding authorization status
• Submit accurate clinical and demographic information to insurance companies
• Track and follow up on pending authorizations to ensure timely approvals
• Maintain detailed and accurate records in billing and EMR systems
• Identify and resolve authorization-related denials or discrepancies
• Ensure compliance with payer guidelines and company policies
• Collaborate with billing, scheduling, and clinical teams to support workflow efficiency
• Monitor authorization expirations and renewals as needed

Requirements

• High school diploma or equivalent; associate or bachelor’s degree preferred
• Previous experience in medical billing, authorizations, or healthcare administration
• Knowledge of insurance verification and prior authorization processes
• Familiarity with CPT, ICD-10, and HCPCS codes preferred
• Experience working with EMR/EHR and medical billing software
• Strong attention to detail and organizational skills
• Excellent communication and customer service abilities
• Ability to manage multiple tasks and meet deadlines
• Understanding of HIPAA regulations and healthcare compliance standards
• Ability to work independently and collaboratively in a fast-paced environment

Benefits

1. Comfortable working U.S. hours
2. Remote work from home

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