Medical Insurance Verification Specialist

3 weeks ago

Quezon City, Philippines MicroSourcing Full time

Medical Insurance Verification Specialist (Spanish Bilingual)

Site: 1880 Building, Eastwood, Libis, Quezon City. Work set-up: Onsite and Nightshift.

Overview

Position title: Medical Insurance Verification Specialist (Spanish Bilingual).

Job Summary

The Patient Account Representative II performs intermediate insurance verification and authorization duties with a growing level of responsibility. In addition to verifying insurance, this position coordinates with clinical departments to ensure accurate scheduling for covered services, resolves moderate issues with payers, and supports pre-visit readiness for patients.

Key Responsibilities
  • Perform detailed insurance verification for outpatient and in-office procedures.
  • Identify and flag non-covered services or potential coordination of benefits issues.
  • Initiate and follow up on prior authorization requests, including appeals if necessary.
  • Maintain organized tracking logs for authorizations and coverage status.
  • Communicate coverage details to patients and collect out-of-pocket estimates if applicable.
  • Serve as a subject matter resource to Patient Account Rep I staff.
  • Work insurance queues to resolve pre-service issues that may delay care.
  • Report payer trends or systematic verification issues to leadership.
Qualifications

Must-have

  • Spanish/English bilingual (phone-ready).
  • Healthcare experience in one or more of the following:
    • Insurance eligibility/benefits verification
    • Referrals/prior authorizations (RBMs like eviCore/Carelon/NIA)
    • Payer portals & benefits lines, EOBs, COB
    • EMR/PM experience (eCW preferred, others OK)
    • Basic understanding of CPT/ICD-10, POS 11, specialist copay vs deductible/coinsurance
  • Strong phone etiquette, documentation accuracy, and HIPAA awareness
  • 3+ years of experience in a medical office or insurance verification role.

Nice to have

  • Experience working with centralized call centers or outsourcing teams
About MicroSourcing

With over 9,000 professionals across 13 delivery centers, MicroSourcing is the pioneer and largest offshore provider of managed services in the Philippines.

Our commitment to 100% YOU

MicroSourcing firmly believes that our company's strength lies in our people's diversity and talent. We are proud to foster an inclusive culture that embraces individuals of all races, genders, ethnicities, abilities, and backgrounds. We provide space for everyone, embracing different perspectives, and making room for opportunities for each individual to thrive.

At MicroSourcing, equality is not merely a slogan - it's our commitment. Our way of life. Here, we don\'t just accept your unique authentic self - we celebrate it, valuing every individual\'s contribution to our collective success and growth. Join us in celebrating YOU and your 100%

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