medical/dental insurance and prior authorization verifier

10 hours ago

Karachi, Sindh, Pakistan Teamficient Full time $40,000 - $80,000 per year

(REMOTE) MEDICAL/DENTAL INSURANCE AND PRIOR AUTHORIZATION VERIFIER

Company: Teamficient -

Salary Range: TBD (Negotiable for highly experienced candidates)

Time Range: Between 7 AM – 7 PM CST (Graveyard Shift)

Working Hours: 9-hour shift (8 working hours + 1-hour break)

Days Off: TBD (2 days per week)

Job Overview

We are looking for a well-organized Medical/Dental Insurance and Prior Authorization Verifier to be involved in a wide range of support activities in our insurance and authorization department. You will also assist in creating policies, processes, and documents. Under this role, the Insurance and Prior Authorization Verifier will be working directly with one of our customers and delivering the tasks outlined in the responsibilities section – see below.

Key Responsibilities

  • Verify patient insurance coverage, eligibility, and benefits prior to appointments and procedures.
  • Conduct in-network and out-of-network checks across multiple U.S. insurance providers.
  • Perform full insurance breakdowns (deductibles, copays, coinsurance, out-of-pocket maximums, coverage limitations, prior authorization requirements).
  • Conduct eligibility checks using insurance portals and payer websites.
  • Prepare and submit comprehensive prior authorization requests with required clinical documentation.
  • Collaborate with healthcare providers to gather information and facilitate the authorization process.
  • Monitor and follow up on prior authorization requests, maintaining detailed records of communications.
  • Investigate and resolve insurance denials, including resubmissions and appeals when necessary.
  • Communicate with insurance representatives to clarify coverage and resolve discrepancies.
  • Communicate with patients regarding the authorization process, potential delays, and financial responsibilities.
  • Document verification and authorization details accurately in the EMR/EHR or practice management system.
  • Work with clinic staff to flag coverage issues and prevent claim denials.
  • Ensure compliance with HIPAA, healthcare regulations, and insurance company policies.

Qualifications & Requirements

  • Minimum 2 years of experience in U.S. healthcare insurance verification and/or prior authorization.
  • Strong knowledge of major U.S. insurance carriers (Medicare, Medicaid, PPOs, HMOs, commercial plans).
  • Proficiency in using insurance portals, clearinghouses, and EMR/EHR systems.
  • Excellent English communication skills (written and verbal).
  • Ability to confidently speak with insurance representatives and summarize findings clearly for providers.
  • Detail-oriented, organized, and capable of managing high-volume verifications and authorizations daily.

Preferred Qualifications

  • Experience handling complex prior authorizations, denials, and appeals.
  • Prior work with multi-specialty practices or high-volume clinics.
  • Familiarity with ICD-10, CPT coding, and medical necessity criteria.

Technical Requirements (Work-From-Home Setup)

  • Computer: Minimum Intel Core i5, 8GB RAM (16GB preferred)
  • Internet: Reliable connection (backup ISP required)
  • Headset: USB noise-canceling headset
  • Power Backup: UPS/generator or alternative work location in case of power outages
  • Workspace: Quiet, distraction-free home office setup

This is a long-term opportunity to work with an experienced and supportive team in a fully remote setting while making a difference in the healthcare industry.

Job Type: Full-time

Work Location: Remote

  • Eligibility, Benefits and Prior Authorization Specialist

    1 week ago

    Karachi, Sindh, Pakistan Premier MBC Full time $70,000 - $120,000 per year

    Work shift: Night shift from 6 pm to 3 amWork Location: Shahrah e Faisal, KarachiEducation: BachelorsExperience: 1+ years in Eligibility, Benefits, and Prior Authorization under any Medical Billing company.Benefits:Dinner, OPD 8%, EOBI, PF 8% and Saturday/Sunday off.Job Description:Verification of Insurance Information (Provided by Practice Front Office /...

  • Medical Biller

    6 days ago

    Karachi, Sindh, Pakistan MacCare Full time 600,000 - 1,800,000 per year

    Job description:We seek candidates to join our organization as Medical Billers for night shift operations. The Medical Biller is responsible for managing the billing and coding process for medical services provided by the healthcare facility. This position requires attention to detail, familiarity with healthcare insurance policies, medical terminology, and...

  • Patient Outreach Specialist

    2 weeks ago

    Karachi, Sindh, Pakistan Mac Care Full time 900,000 - 1,200,000 per year

    Job descriptionWe seek doctors and physicians to join our organization as Patient Outreach Specialists for night shift operations. The specialist will handle both inbound and outbound patient calls, providing essential communication and support regarding patient scheduling, insurance verification, and medical records management.Job Description:Answer phone...

  • Medical Billing Specialist

    1 week ago

    Karachi, Sindh, Pakistan Elint RCM Solutions LLC Full time 400,000 - 600,000 per year

    Company DescriptionElintRCM Solutions is dedicated to transforming healthcare providers' management of their revenue cycle. We offer streamlined, scalable, and fully compliant Revenue Cycle Management (RCM) services to practices across the U.S. Our comprehensive solutions support providers at every revenue cycle stage, focusing on accuracy, compliance, and...

  • Patient Care Advocate

    4 days ago

    Karachi, Sindh, Pakistan ZUE Full time 1,200,000 - 2,400,000 per year

    Position: Patient Care AdvocateLocation:Karachi (On-site)Shift:06:00 PM – 03:00 AM (PST)Employment Type:Full-timePosition OverviewThePatient Care Advocateacts as the primary liaison between patients, providers, and internal departments to ensure a seamless and compassionate care experience. This role demands precision, empathy, and a solid understanding of...

  • claim executive

    2 weeks ago

    Karachi, Sindh, Pakistan TPL Insurance Full time 600,000 - 1,200,000 per year

    Company DescriptionTPL Insurance (TPLI) is a leader in providing seamless insurance services in Pakistan through advanced Insurtech infrastructures and a 24/7 Contact Center. The TPL Insurance Mobile App is a top Insurtech platform in Pakistan, offering comprehensive insurance experiences from policy issuance to claim lodging, self-surveys, endorsements,...

  • Deputy Manager – Medical Services

    2 weeks ago

    Karachi, Sindh, Pakistan 360 Human Capital solutions pvt ltd Full time 900,000 - 1,200,000 per year

    Job Title: Deputy Manager – Medical ServicesLocation: Head Office, KarachiJob Description:Our client, a reputable PSX-listed manufacturing company, is seeking a proactive and experienced Deputy Manager – Medical Services to join their team. This is a key position responsible for managing medical services across the organization, ensuring occupational...

  • Medical Biller

    1 week ago

    Karachi, Sindh, Pakistan MediSync RCM Full time 30,000 - 60,000 per year

    Company Description:MediSync RCM is a Healthcare revenue cycle management (RCM) company dedicated to delivering measurable improvements to healthcare providers across the USA. Our solutions streamline revenue cycle operations, minimize errors, and drive continuous innovation for optimal financial performance. From boosted profitability to regulatory...

  • Auto Insurance Sales Specialist

    4 days ago

    Karachi, Sindh, Pakistan ENCENTER Solution Full time 600,000 - 1,200,000 per year

    PremierDrive InsurancePremierDrive Insurance is seeking experienced and enthusiastic professionals with strong English communication skills and a solid background in customer service, claims support, and inbound/outbound insurance sales. Selected candidates will serve as key representatives between PremierDrive and our U.S.-based policyholders, ensuring all...

  • Corporate Sales Executive

    6 days ago

    Karachi, Sindh, Pakistan JAP Insurance Brokers Full time 60,000 - 240,000 per year

    Location:KarachiSalary:PKR 60,000 (Basic) + Attractive Commissions + Health Insurance BenefitsExperience:Fresh candidates can apply (Insurance experience preferred)About JAP Insurance BrokersJAP Insurance Brokers is a leading insurance brokerage firm specializing incorporate health and general insurancesolutions. We partner with Pakistan's top insurance...