Authorization & Eligibility Specialist (Onsite)

2 weeks ago


Davao City, Philippines Snapscale Full time

Overview Snapscale is looking for an expert Authorization and Eligibility Specialist to perform the following functions: Verify insurance eligibility, benefits, exclusions, deductibles, co-pays, and co-insurance for occupational and speech therapy patients. Contact insurance providers to clarify discrepancies or misquoted benefits. Enter benefit details into forms and calculate patient responsibility (worst- and best-case coverage scenarios). Complete good-faith estimates. Check, submit, and track therapy authorization requirements. Ensure all services have valid authorizations to prevent denials. Upload and process data from E-Bridge Software; maintain accurate and updated EMR records. Review medical records to confirm authorization and eligibility accuracy. Use medical terminology and coding knowledge for eligibility and authorizations. Re-verify insurance coverage based on denial codes. Protect patient confidentiality and comply with HIPAA regulations. Work with providers and staff to resolve authorization and billing issues. Perform follow-up tasks related to billing as directed by the Senior Medical Billing & RCM Manager. Qualifications 5+ years of experience handling insurance authorizations, eligibility, and benefits verification for OT, PT, and SLP clinics (pediatrics preferred) Proficient in insurance portals, calling insurers, and EMR data entry Ideal candidate has experience with Fusion Web Clinic EMR (Therapy Brands) Background in private practice settings preferred Strong medical terminology, anatomy, and insurance billing knowledge Detail-oriented, hardworking, and diligent Tech-savvy and quick to learn new EMR systems Accurate in coding and billing with strong understanding of reimbursement processes Clear communicator; able to work effectively with providers, insurers, and patients Highly reliable and responsive #J-18808-Ljbffr



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