Open to opportunities

Hamza Ali

@hamzaali23

Senior insurance verification & prior authorization specialist ensuring HIPAA-compliant approvals for imaging, surgeries, and medications.

Pakistan

Message

What I'm looking for

I’m looking for a HIPAA-focused role where I can manage insurance verification and prior authorizations end-to-end—imaging, surgeries, and pharmacy—handle appeals accurately, and use Medisoft and Excel to support fast, compliant approvals.

I focus on insurance verification and prior authorization workflows that keep care moving—starting with eligibility & benefits verification and then building the documentation needed for approvals. I’m results-oriented, flexible, and careful about getting details right under HIPAA requirements.

In my roles, I obtain prior authorization from different payers for diagnostic imaging and radiology (MRI Scan, CT scan, MRA Scan, CAT Scan; Ultrasound, X-Rays), interventional pain management, and therapy services (Physical Therapy, Occupational Therapy). I also handle inpatient and outpatient surgery authorizations (spine surgery, orthopedic surgery) and medication authorizations through medical and pharmacy plan pathways (Medicare Part D & Part B, buy & bill product, and specialty pharmacy).

I’m also experienced in denied-case appeals by referencing specific clinical guidelines, and I submit prior authorizations through forms, fax, online processes, and calls as needed. I support efficient operations with tools like Medisoft and Microsoft Excel/Office/Word, while using analytical, detail-oriented, and research skills to resolve questions and reduce delays.

Experience

Work history, roles, and key accomplishments

Current

Senior Insurance & Prior Auth Specialist

Current

ScribeRunner

Nov 2025 - Present (8 months)

Handled medical and pharmacy insurance verification and prior authorizations. Ensured HIPAA compliance, submitted authorization documentation, and filed appeals for denied cases across diagnostic imaging, radiology, interventional pain management, therapy, and surgery requests.

Insurance Verification Prior Authorizations HIPAA compliance Diagnostic Imaging MRI MRA CAT Scan Radiology Physical Therapy Occupational Therapy Pharmacy Authorizations Specialty Pharmacy Inpatient & Outpatient Surgery Authorization Spine Surgery Authorization

Current

Senior Insurance Verification & Prior Authorization Specialist

Current

ScribeRunner

Nov 2025 - Present (8 months)

Basic Working:
Medical and Dental Insurance Verification (Eligibility & Benefits Verification) & Prior Authorization {Diagnostic Imaging, Radiology (Ultrasound / XR), Interventional Pain Management, Physical Therapy, Occupational Therapy, Pharmacy (Drugs) Authorization (Medicare Part D & Part B) under medical plan (Buy & Bill Product) or under pharmacy plan (through specialty pharmacy). Inpatient

Insurance Verification & Prior Authorization Specialist

ScribeRunner

Dec 2023 - Dec 2024 (1 year)

Basic Working:
Insurance Verification (Eligibility & Benefits Verification) & Prior Authorization {Diagnostic Imaging, Radiology (Ultrasound / XR), Interventional Pain Management, Physical Therapy, Occupational Therapy, Pharmacy (Drugs) Authorization (Medicare Part D & Part B) under medical plan (Buy & Bill Product) or under pharmacy plan (through specialty pharmacy).
Roles & Responsibilities:
Ens

Medical Authorization Benefit Verification Medical Claims Processing Health Insurance Microsoft Excel Insurance Verification Microsoft Office Microsoft Word

Prior Authorization Specialist

Medway LLC

Jan 2023 - Dec 2023 (11 months)

Provided prior authorization support and related medical billing activities at Medway LLC.

Analytical Skills Detail Oriented Interpersonal Skills Prior Authorizations Medical Billing Research Skills Insurance Authorization

Prior Authorization Specialist

Complete Operations Management Solutions

Dec 2020 - Dec 2022 (2 years)

01)- Call Dr.s offices & insurance carries to obtain the prior authorization for patient medication.
02)- Resolve issues & questions while maintain the HIPPA regulations.
03)- Data entry and market research.
04)- Submit prior authorizations with different companies via form, fax, or online/call.

Analytical Skills Detail Oriented Interpersonal Skills Prior Authorizations Medical Billing Research Skills