CSR for Healthcare Account/s

2 weeks ago

Pasig, National Capital Region, Philippines GeBBS Healthcare Solutions (Philippines), Inc. DUP2 Full time
CSR for Healthcare Account/s (Authorization Specialist)

GeBBS Healthcare Solutions (Philippines), Inc. DUP2

Full time

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An Authorization Specialist plays a crucial role in the healthcare industry, ensuring that patients receive the necessary approvals for medical services and treatments.

Duties and Responsibilities

  • Manage the submission and follow-up process for insurance payors, including Medicare, Medicaid, HMOs, and PPOs.
  • Perform initial benefit verification and secure pre-surgical authorization for new cases, collaborating closely with all payers.
  • Meticulously document case status, actions, and outcomes in a contact management database using the "who, what, where, when, how" approach to ensure accurate records.
  • Communicate with healthcare provider (HCP) offices and sales. representatives regarding case inquiries, missing information, and benefits
  • Notify relevant internal departments based on received information, including complaint handling and adverse event notifications.
  • Adhere to all healthcare regulations, including HIPAA, to ensure patient privacy and confidentiality of medical information.

Minimum Qualifications:

  • Preferably, with a degree in a medical allied course or, with 1 to 2 years of experience in Authorization. Fresh graduates from medical allied courses are welcome to apply.
  • Has an understanding of clinical terminologies
  • Familiar with insurance carrier guidelines.
  • With knowledge of state guidelines related to referrals and prior authorization.
  • Proficiency in these coding systems (ICD-10 and CPT Codes)
  • With awareness of state and federal coverage and authorization rules.
  • Can start ASAP and open to work onsite in the following sites (Ortigas, Eastwood, Mandaluyong, or MOA)
  • Excellent phone etiquette and excellent verbal, written, and interpersonal skills.
  • Ability to multi-task, organize, and prioritize work.

For interested applicants and referrals, you may either visit one of our offices from Mondays to Fridays between 7 PM to 11 PM or send your updated resumes to:

Ortigas, Pasig City (One Corporate Center)

Your application will include the following questions:

What's your expected monthly basic salary?

Do you have customer service experience?

How would you rate your English language skills?

Have you worked in a call centre before?

How much notice are you required to give your current employer?

How many years' experience do you have as a Healthcare Associate?

How many years' experience do you have as an Authorization Staff?

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