Quality Auditor

4 weeks ago


Metro Manila, Philippines AGS health Full time

Qualifications

At least 2 years of relevant BPO experience as a Quality Auditor for Clinical AuthorizationWilling to report onsite and on a night shift schedule

Responsibilities

Contact insurance carriers to verify patient’s insurance eligibility, benefits and requirements. Request, track and obtain pre-authorization from insurance carriers within time allotted for medical and services.Review, request, follow up and secure authorizations for high dollar cost oncology chemotherapy drugs.Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations. Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed. Review denials and follow up with provider to obtain medically necessary information to submit an appeal of the denial.Prioritize the incoming authorizations by level of urgency to the patient.Manage correspondence with insurance companies, physicians, specialists, and patients as needed, including documenting in the EHR as appropriate. Respond to clinical questions regarding payer medical policy guidelines

 

What We Offer

Excellent Company CultureDay 1 Health Insurance, plus free dependentFixed schedule and fixed weekends offNon-Toxic | Blended Non-Voice Account Employee Referral IncentiveOpportunity for promotionFree Training as Clinical Authorization Specialist

 

About Us

We are an analytics-driven, technology-enabled revenue cycle management company that alleviates financial and administrative burdens on healthcare providers by providing billing, coding, automation and analytics services.
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