Murtaza Rizvi
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Prior Authorization Specialist & Healthcare Operations| RCM, WC & PI Billing Specialist
Karachi, Sindh, Pakistan
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Résumé
Jobs
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Senior Prior Authorization SpecialistPsychPlusJun 2026 - Current (4 months)As a Senior Prior Authorization Specialist, I manage complex authorization processes to ensure timely patient access to psychiatric treatments, medications, and behavioral health services. My responsibilities include: ✔ Serving as a subject matter expert for prior authorizations involving psychiatric evaluations, therapy services, behavioral health treatments, and mental health programs ✔ Managing authorization requests for psychiatric medications, including Trazodone, Zoloft, Fluoxetine, Sertraline, Rexulti, and other related therapies ✔ Overseeing end-to-end authorization workflows and patient access support for Spravato treatment, ensuring compliance with payer requirements and treatment protocols ✔ Conducting follow-ups, escalations, re- Prior Authorization SpecialistPsychPlusMar 2025 - Jun 2026 (1 year 4 months)As a Prior Authorization Specialist, I specialize in managing approvals and access for psychiatric treatments, medications, and related healthcare services. My role involves: ✔ Processing prior authorizations for psychiatrist visit codes, therapy services, and mental health treatments ✔ Handling approvals for antidepressant and psychiatric medications such as Trazodone, Zoloft, Fluoxetine, Rexulti, Sertraline, and other related prescriptions ✔ Specializing in prior authorizations and patient support for Spravato treatment ✔ Conducting follow-ups, status checks, reconsiderations, and appeals for pending or denied requests ✔ Coordinating medication shipment scheduling from specialty pharmacies to clinics for timely treatment ✔ Informing patie
- OOperations Team Lead - RCM | Workers' Comp & PIJul 2024 - Mar 2025 (9 months)Promoted to Operations Team Lead (OTL) based on performance, reliability, and operational knowledge Supervised daily operations for RCM, Workers’ Compensation (WC), and Personal Injury (PI) billing processes Assigned tasks and managed workload distribution among team members to ensure timely completion of operational targets Monitored employee productivity and maintained workflow efficiency across billing and support functions Conducted regular audits and quality checks on team work to ensure accuracy, compliance, and process adherence Reviewed claims, VOB, scheduling, referrals, reporting, and billing activities performed by team members Provided guidance, training, and real-time support to employees for issue resolution and process improv
- OOperations Support Executive - RCM | Workers' Comp & PIJul 2023 - Jul 2024 (1 year 1 month)Managed end-to-end support for RCM, Workers’ Compensation (WC), and Personal Injury (PI) medical billing processes Performed Verification of Benefits (VOB) to confirm patient eligibility, coverage details, copays, and deductibles Coordinated patient scheduling and referrals, ensuring smooth front-end operations and continuity of care Supported medical billing lifecycle including charge entry, claim submission, follow-ups, and denial handling Reviewed and analyzed Accounts Receivable (AR) aging reports to identify outstanding claims and prioritize collections Collaborated with coding teams to ensure accurate medical coding and reduce claim rejections Developed and tracked KPIs for sales representatives and collections officers to monitor per
Education
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- Virtual University of Pakistan (VU) — Bachelor of Business Administration - BBA, Business Administration and Management,Virtual University of Pakistan (VU)Jan 2026 - Current (9 months)
- University of Karachi — Associate Degree in CommerceUniversity of KarachiJan 2023 - Dec 2025 (3 years)