Prior Authorization Specialist Medical Record USA
Citadel Healthcare Management (PVT) LTD. provides healthcare management services for practices across North America. Our dedicated team supports a wide range of medical administration tasks, working collaboratively across multiple disciplines.
Our mission is to offer employees meaningful opportunities to apply their expertise, grow in their careers, and contribute to the organization’s ongoing success.
We are committed to creating a workplace where employees feel valued, supported, and motivated. By fostering a collaborative and engaging environment, we ensure that every contribution is recognized and appreciated.
At Citadel, diversity and inclusion are at the heart of our culture. We welcome individuals from all backgrounds—regardless of gender, ethnicity, age, religion, lifestyle, or disability—and embrace the unique perspectives and experiences they bring. Through teamwork, innovation, and continuous professional development, we empower our employees to thrive and drive progress within the organization.
Location: Karachi
Full-Time
Work from Office
Key Responsibilities
Review medical records and provider orders to determine authorization requirements.
Submit prior authorization requests to insurance companies via portals, fax, or phone.
Track and follow up on pending authorizations to ensure timely approvals.
Communicate with physicians, nurses, and patients regarding authorization status.
Document all authorization activities in the billing system or EMR.
Resolve denials or rejections by providing additional clinical documentation.
Maintain compliance with HIPAA and payer-specific guidelines.
Qualifications
Bachelor’s degree preferred; healthcare or billing certification a plus.
2+ years of 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 skills.
Ability to work independently and manage multiple requests simultaneously.
Skills & Competencies
Detail-oriented with strong analytical skills.
Proficiency in EMR systems and Microsoft Office Suite.
Knowledge of medical terminology and clinical documentation.
Problem-solving mindset with ability to handle denials effectively.
Benefits
- Competitive salary and benefits package.
- Professional growth opportunities in healthcare administration.
- Collaborative work environment supporting patient care.