Prior Authorization

3 days ago

Quezon City, Philippines Swift-up Full time

Responsibilities: Submit requests for prior authorizations to insurance companies or third-party payers. Follow up on pending authorizations and ensure timely processing to prevent delays in patient care. Document authorization information in patient records and update as needed. Verify patients' insurance eligibility, benefits, and coverage limitations. Check for requirements related to deductibles, copayments, and out-of-pocket expenses. Inform patients of their authorization status and any potential delays or issues. Work with physicians, nurses, and other healthcare providers to ensure accurate information is submitted. Investigate reasons for denied authorization requests and resubmit or appeal as appropriate. Communicate with insurance representatives to resolve any authorization issues. Maintain accurate records of all authorization requests, approvals, and denials. Ensure compliance with healthcare regulations, insurance policies, and privacy laws (e.g., HIPAA). Note: 15 days onsite per year #J-18808-Ljbffr

  • Prior Authorization Specialist

    1 week ago

    Quezon City, National Capital Region, Philippines 1840 & Company Full time ₱1,200,000 - ₱2,400,000 per year

    We are seeking a detail-oriented and experienced Prior Authorization Specialist to manage  the full lifecycle of prior authorizations (PAs) for medical services. The ideal candidate will be responsible for timely submission, meticulous follow-up, and effective resolution of all prior authorization requests and subsequent appeals. This role is critical in...

  • Prior Authorization Specialist

    1 week ago

    Quezon City, National Capital Region, Philippines 1840&Company Full time ₱1,200,000 - ₱2,400,000 per year

    We are seeking a detail-oriented and experienced Prior Authorization Specialist to manage the full lifecycle of prior authorizations (PAs) for medical services. The ideal candidate will be responsible for timely submission, meticulous follow-up, and effective resolution of all prior authorization requests and subsequent appeals. This role is critical in...

  • Prior Authorization Specialist

    3 days ago

    Batangas City, Philippines 1840 & Company Full time

    We are seeking a detail-oriented and experienced Prior Authorization Specialist to manage the full lifecycle of prior authorizations (PAs) for medical services. The ideal candidate will be responsible for timely submission, meticulous follow-up, and effective resolution of all prior authorization requests and subsequent appeals. This role is critical in...

  • Prior Authorization Assistant

    3 days ago

    Cebu City, Philippines HirebizMed Full time

    Were looking for a detail-oriented and experienced Prior Authorization Specialist to join our growing team. In this role, you will be responsible for handling pre-certifications, verifying insurance coverage, and ensuring timely approvals for medical procedures, medications, and services. Your work will directly support patients in accessing the care they...

  • Pharmacy Prior Authorization Specialist

    23 hours ago

    Quezon City, Philippines Intelassist Full time

    EOR: One Workforce GlobalEmployment Type: Full-Time EmploymentWork Setup: 100% Onsite (Office location in either Eastwood, Clark or Muntinlupa)Work Schedule: Night Shift (Following U.S. Time Zone) Position Overview The Pharmacy Prior Authorization Specialist is responsible for handling and processing medication prior authorization (PA) requests with minimal...

  • Pharmacy Prior Authorization Specialist

    4 days ago

    Quezon City, National Capital Region, Philippines Intelassist Full time ₱250,000 - ₱450,000 per year

    EOR: One Workforce GlobalEmployment Type: Full-Time EmploymentWork Setup: 100% Onsite (Office location in either Eastwood, Clark or Muntinlupa)Work Schedule: Night Shift (Following U.S. Time Zone)Position Overview:The Pharmacy Prior Authorization Specialist is responsible for handling and processing medication prior authorization (PA) requests with minimal...

  • Certified Pharmacist

    3 days ago

    Quezon City, Philippines Intelassist Full time

    EOR: One Workforce Global Employment Type: Full-Time Employment Work Setup: 100% Onsite (Office location in either Eastwood, Clark or Muntinlupa) Work Schedule: Night Shift (Following U.S. Central Time Zone) Duties and Responsibilities Intake and triage PA requests from providers, pharmacy, and patients; confirm eligibility and benefits. Gather required...

  • Prior Authorization Unit Supervisor

    7 days ago

    Tarlac City, Philippines Enterprise Mangement Solutions Inc Full time

    This is a Philippine-based position; NOT a US based position and the pay rate is not in US currency. ABOUT FREEDOM HEALTH SYSTEMS, INC: Freedom Health Systems, Inc. is a mission-driven healthcare advisory and management consulting firm that partners with behavioral health and human services organizations to improve access, equity, and operational excellence....

  • Utilization Review Nurse, USRN

    3 days ago

    Pasig City, Philippines Visaya KPO Full time

    Role Overview: We are seeking a skilled Utilization Management/Review Nurse to join our team. This role is essential in ensuring patients receive appropriate, timely, and cost-effective care by reviewing medical records, treatment plans, and healthcare resource utilization. Key Responsibilities: Conduct concurrent and retrospective reviews of patient...

  • Healthcare CSR For Prior Authorization

    1 week ago

    Mandaluyong City, National Capital Region, Philippines ISTA Solutions, Inc. Full time ₱180,000 - ₱300,000 per year

    DescriptionISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Healthcare Customer Service Representative to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride...