Prior Authorization Specialist

6 days ago


Pasig, Philippines Connext Full time

Prior Authorization Specialist – Connext (Pasig, Philippines) Connext Global Solutions is a dedicated team of business process outsourcing experts. We are currently hiring a Prior Authorization Specialist to work with our client in the United States. What’s in it for you? Competitive compensation Perfect Attendance Bonus Life insurance HMO insurance Great company culture Annual merit increase 25% night differential Php 5,000 sign‑on bonus Job Responsibilities The Prior Authorization Specialist conducts insurance verifications and obtains prior authorizations for a diverse range of services. Verify patient eligibility and benefits via portal and/or phone call, collecting referral and authorization requirements across multiple payers, states, insurance products, and specialties within customer SLAs. Work closely with providers to collect accurate patient and medical records and communicate authorization decisions. Required Qualifications Minimum of one year experience with medical billing and/or understanding of benefits including deductibles, co‑insurance, out‑of‑pocket and benefits exclusions. Familiar with provider software, including Electronic Medical Record Systems (EMR/EHR) and Practice Management Systems (PMS). Experience with HMOs, PPOs, POSs, EPOs, Medicare, Medicaid and understanding of each through the referral and authorization process. Employment Details Full‑time | Entry level | Health Care Provider | Health and Human Services #J-18808-Ljbffr



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