Prior Authorization Specialist

Shift Schedule: Nightshift - 8PM-5AMWork Setup: Onsite - McKinley, Taguig Overview:A Medicine and Radiology Prior Authorization Specialist plays a key role in ensuring that patients receive the necessary medical services, procedures, and imaging tests by obtaining insurance approval. This specialist navigates complex payer requirements, ensuring compliance...

Medical Prior Authorization-Insurance Verification SpecialistPosition Summary:The Prior Authorization Specialist plays a crucial role in the healthcare industry by ensuring that medical services, procedures, and medications are approved by insurance companies or third-party payers before they are rendered or prescribed. They work closely with healthcare...

QualificationsAt least 2 years of relevant BPO experience as a Quality Auditor for Clinical AuthorizationWilling to report onsite and on a night shift scheduleResponsibilitiesContact insurance carriers to verify patient’s insurance eligibility, benefits and requirements. Request, track and obtain pre-authorization from insurance carriers within time...

Be a part of our fast-growing team and unchain all the possibilities!What is your mission?We are looking for a Medical Billing Specialist to manage accurate billing data, verify U.S. health insurance eligibility, submit claims with proper codes, and resolve denials or rejections. The role includes handling billing inquiries, posting payments, and ensuring...

This is for a direct hire and permanent position.  Job SummaryThe Liaison Officer / Inpatient Services Specialist will be responsible for generating, reviewing, approving, disapproving, issuing, and updating of Letters of Authorization within approved authority limits. They will also be responsible for keeping track of and updating of the member billing as...

Job Duties and Responsibilities· Prioritize incoming authorization and referral requests according to queue urgency· Review patient’s clinical and chart documentation related to the service submitted by the provider’s office· Obtain and/or follow up on authorization and referral requests from the patient’s payer/s through any of the following...

Be a part of our fast-growing team and unchain all the possibilitiesWhat is your mission?We are looking for a Medical Billing Specialist to manage accurate billing data, verify U.S. health insurance eligibility, submit claims with proper codes, and resolve denials or rejections. The role includes handling billing inquiries, posting payments, and ensuring...

QUALIFICATIONS:Candidate must possess a Bachelor's Degree in PharmacyNo license or prior experience requiredFresh graduates are welcomeExcellent oral and written communication skillsDetail-orientedRESPONSIBILITIES:Prepare and submit reports to the regulatory authorities such as Food and Drug Administration (FDA) and Bureau of Animal Industry (BAI)support...

The RequirementsRequired Skills and knowledge:•  Bachelor’s degree preferred•   3+ years of working experience dealing with US health and welfare plans, ideally gained in a benefit consulting/brokerage firm, Health Plan, Third Party Administrator, Regulatory Agency, Legal/Compliance Firm, or insurance company. Prior experience working with US based...

Job Summary:The Health Emergency Response Specialist is responsible for taking care of the sick or injured in emergency medical settings. The role provides a quick reaction and competent care to employees, patients or victims (including general public as instructed) who are in life threatening conditions. He/she responds to emergency calls, performing,...

Job Specifications:Open to hybrid work arrangement.Graduate of Bachelor’s Degree – RN License is required.Minimum of 2 years experience and must have impressive track record in reviewing treatment plans and services to ensure the efficient use of patient utilization systems and quality care using appropriate medical resources.Effective team...

Emerson’s 133 years of history have been filled with achievements and challenges that have driven innovative thinking and bold transformations, molding us into the company we are today. By joining us as a Lead Specialist, General Ledger, you will pioneer and set up the process and perform reviews and authorizations of financial transactions such as bank...

Are you ready to take your career to the next level? Now is an exciting time to join the Fluor team in the Philippines! Join us and enjoy the following!• Competitive salary• Various allowances• Time Off with Pay• Alternating Friday Off Week• Health and Life Insurance• Retirement Plan• Savings and Investment Plan• Employee Assistance...

Job Title: Compensation and Benefits SpecialistLocation: Makati CityDepartment: Human ResourcesReports To: HR / Office ManagerJob Type: Full-timeA Compensation and Benefits Specialist is responsible for managing an organization's compensation structures and employee benefits programs. Their primary goal is to ensure that the company offers competitive...

Job Title: Real Estate Virtual Assistant - Technical Operations Specialist Position Overview: We are looking for a meticulous and proactive Technical Operations Specialist to join our team remotely. This role is crucial for the smooth onboarding and offboarding of agents and staff, providing ongoing technical support for internal operations. The ideal ...

The Taxation Specialist will play a crucial role in supporting the operations and Human Resources departments, ensuring compliance with all free trade zone requirements, and handling various ad-hoc requests including payroll related tasks and monthly filings and registrations. This position requires a strong understanding of tax regulations, excellent...

The Surveying Technical Specialist shall be responsible for updating the measurement of both selling and non-selling areas in the stores as a requirement in the computation of the following:Profitability of the division and brandsSales Productivity of brandsRental charges to Affiliate and Concessionaire brands with MGR ratesRental charges for Tenants with...

Job SummaryWe are seeking a NetSuite Specialist to provide expert support and implement tailored NetSuite solutions aligned with business objectives and regulatory requirements. This role involves documenting business needs, leading analytics and report-writing efforts, and managing data integration projects. The specialist will oversee system integrity...

The Megawide Group has a vision of a First-World Philippines. This vision united all its businesses, driven by a mission to deliver engineering excellence and innovation in its diverse assets throughout the Philippines.We are a proud Quadruple A contractor in the Philippines, an exceptional innovator in Engineering, Procurement, and Construction (EPC), and...

Job Title: Real Estate Virtual Assistant - Technical Operations Specialist Position Overview: We are looking for a meticulous and proactive Technical Operations Specialist to join our team remotely. This role is crucial for the smooth onboarding and offboarding of agents and staff, providing ongoing technical support for internal operations. The...