Prior Authorization

4 weeks 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



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