Authorization Specialist
Overview
We are looking for an Authorization Specialist who is well spoken, confident, and relentless in the right ways. In this position, you will own the authorization process across multiple service lines and payer types, ensuring that every service we bill on behalf of our clients is properly cleared before and during delivery. You will interact directly with insurance companies, managed care organizations, and internal teams — and you will need to navigate those conversations with authority and professionalism.
This is not a passive role. You will be expected to think critically, communicate with precision, and drive resolutions rather than wait for them.
WHAT WE OFFER
- A high-performance team culture where your contributions are visible and valued.
- Competitive compensation based on experience and demonstrated performance.
- Access to professional development resources and pathways for advancement within the RCM field.
- A leadership team that is genuinely invested in your growth and open to ideas that improve how we work.
No. of Vacancies
1
Specific Skills
WHAT WE ARE LOOKING FOR
We are looking for a specific kind of professional someone who commands a room when they speak, follows through without being asked twice, and brings clarity to complex situations. Beyond technical skills, communication and confidence are non-negotiable here.
- Bachelor’s degree in health information management, Healthcare Administration, Business, Actuarial science, Insurance or a other related fields.
- Solid command of CPT, ICD-10, and HCPCS coding as they relate to authorization and medical necessity determinations.
- Proven experience navigating payer portals, authorization platforms, and practice management or EHR systems.
- Exceptional verbal communication skills you speak with confidence, listen carefully, and advocate effectively whether on a call with a payer or presenting an update to leadership.
- Excellent written communication your documentation, emails, and reports are clear, professional, and leave no room for misinterpretation.
- You are organized, self-directed, and capable of managing a high-volume workload without losing accuracy or composure.
- You understand HIPAA and take data confidentiality as a personal and professional responsibility.
- Experience working with automation tools or workflows in a billing environment is a significant advantage.
Responsible For
KEY RESPONSIBILITIES
Prior Authorization & Eligibility
- Manage end-to-end prior authorization requests across a range of medical specialties and payer types, including commercial, Medicare, and Medicaid plans.
- Maintain a live tracking system for all open and approved authorizations, proactively flagging expirations, gaps, or discrepancies.
- Coordinate with clinical teams to obtain and submit clinical documentation required for authorization approvals.
- Assist with concurrent and retrospective utilization review by monitoring approved services against payer criteria and medical necessity guidelines.
- Communicate authorization status, limitations, and continued-stay requirements to internal stakeholders in a timely and accurate manner.
- Escalate cases requiring peer-to-peer reviews or expedited authorization decisions with supporting documentation prepared in advance.
- Investigate authorization-related claim denials, determine root cause, and execute appropriate resolution strategies including reconsiderations and formal appeals.
- Track and report denial patterns, contributing actionable insights that improve front-end authorization accuracy.
- Identify opportunities to leverage automation tools and workflows that reduce manual authorization touchpoints without compromising accuracy.
- Stay current on payer policy updates, coverage criteria changes, and regulatory developments affecting authorization requirements.
Job Nature
Full Time
Job Location
Kampala
Job Level
Sr. Position
How to Apply
Interested candidates can send their resumes to info@revelooptechsystems.com mentioning "Job Title" in the subject line.
Apply Online