Current jobs related to Medical Prior Authorization - Davao City, Davao - Med Supply US
-
Prior Authorization Coordinator
2 weeks ago
Davao City, Davao, Philippines beBee Careers Full timeThe Prior Authorization Specialist plays a crucial role in the healthcare industry, ensuring that medical services and procedures are approved by insurance companies before being rendered or prescribed.Key Responsibilities:Prior Authorization Management: Review and evaluate medical service requests to determine if prior authorization is required. Gather all...
-
Medical Services Approver
2 weeks ago
Davao City, Davao, Philippines beBee Careers Full timeThe ideal candidate will have experience in healthcare administration, medical billing, or insurance coordination, with a strong understanding of insurance plans, prior authorization requirements, and reimbursement processes.Requirements:Education: High school diploma or equivalent; some positions may require an associate's or bachelor's degree in a related...
-
Care Coordinator for Insurance Pre-Approvals
5 days ago
Davao City, Davao, Philippines beBee Careers Full timeMedical Prior Authorization SpecialistThe role of a Medical Prior Authorization Specialist is critical in ensuring that medical services, procedures, and medications are approved by insurance companies before they are rendered or prescribed. This professional works closely with healthcare providers, insurance companies, and patients to gather and submit the...
-
Medical Administrator
1 week ago
Davao City, Davao, Philippines beBee Careers Full timeThe Medical Scheduler role requires a professional with excellent communication skills to handle email and phone correspondence, collect patient information, and schedule appointments.Key Responsibilities:Set appointment schedules for consultation and coordinate with focal persons of LGUs and municipalities for patients residing in their area.Conduct...
-
Medical Scheduler Coordinator
1 week ago
Davao City, Davao, Philippines beBee Careers Full timeMedical Scheduler Job DescriptionThis role involves handling various tasks, including email and phone correspondence, collecting patient information, and scheduling appointments. As the initial point of contact for patients, it's essential to possess excellent customer service skills.Daily Responsibilities:Scheduling appointments for consultation with...
-
Medical Specialist
1 week ago
Davao City, Davao, Philippines beBee Careers Full timeRemote Freelance OpportunityWe are seeking medical experts to contribute their expertise in training generative artificial intelligence models. This freelance opportunity is remote with flexible hours, allowing you to work at your convenience.About the OpportunityThis project involves developing and answering medical questions to help train AI models, as...
-
Medical Insurance Professional
2 weeks ago
Davao City, Davao, Philippines beBee Careers Full timeWe are seeking a skilled Virtual Medical Assistant with expertise in insurance processes to join our team.Key Responsibilities:Verify insurance eligibilityManage pre-authorizations and referralsProcess claims efficientlyThe ideal candidate will have hands-on experience in these areas and be able to work independently in a remote setting. A strong...
-
Remote Healthcare Career Opportunities
1 week ago
Davao City, Davao, Philippines beBee Careers Full timeCareer Opportunities for Virtual Medical AssistantsWe're seeking skilled Virtual Medical Assistants to fill critical roles in our organization. As a Virtual Medical Assistant – Insurance Specialist, you'll play a vital part in supporting medical professionals across the United States. Your expertise will help us deliver high-quality services to patients...
-
Medical Care Specialist
2 weeks ago
Davao City, Davao, Philippines beBee Careers Full timeRegistered Nurse Job SummaryWe are looking for a dedicated and skilled Registered Nurse to join our team. The successful candidate will be responsible for delivering high-quality patient care, working closely with healthcare teams to develop and implement individualized care plans.This is an exciting opportunity to work in a dynamic environment, providing...
-
Medication Management Specialist
2 weeks ago
Davao City, Davao, Philippines beBee Careers Full timeA key responsibility of this role is patient education and medication management. You will need to develop strong relationships with patients to educate them on the appropriate use of medications and provide guidance on managing their health conditions.Key SkillsExcellent communication and interpersonal skills to engage with patients and healthcare...
Medical Prior Authorization
1 month ago
The Prior Authorization Specialist plays a crucial role in the healthcare industry by ensuring that medical services, procedures, and medications are approved by insurance companies or third-party payers before they are rendered or prescribed. They work closely with healthcare providers, insurance companies, and patients to gather and submit the necessary information to obtain prior authorizations. The primary objective of a Prior Authorization Specialist is to navigate the complex process of securing pre-approval for healthcare services, minimizing delays in treatment and optimizing reimbursement.
Key Responsibilities:
- Prior Authorization Management: Review and evaluate medical service requests, including procedures, tests, surgeries, and medications, to determine if prior authorization is required. Gather all relevant medical documentation, such as medical records, test results, and clinical notes, to support the authorization request.
- Insurance Verification: Verify patient insurance coverage, including benefits, eligibility, and limitations. Obtain and document necessary insurance information to ensure accurate billing and reimbursement.
- Documentation and Communication: Prepare and submit prior authorization requests to insurance companies or third-party payers, adhering to their specific guidelines and requirements. Maintain accurate and organized records of all authorization requests, follow-up activities, and outcomes. Communicate with healthcare providers, insurance companies, and patients to obtain additional information, clarify requirements, and provide updates on the status of authorizations.
- Policy and Compliance: Stay up-to-date with insurance policies, guidelines, and industry regulations related to prior authorizations. Ensure compliance with all legal and regulatory requirements, including patient privacy and confidentiality (HIPAA).
- Appeals and Denials: Assist with appeals and denials related to prior authorizations, working closely with healthcare providers and insurance companies to gather necessary information and submit appeals within specified timelines. Analyze denials and identify trends or areas for improvement to minimize future denials.
- Quality Assurance: Perform periodic audits of prior authorization processes to identify any gaps or inefficiencies. Collaborate with team members and stakeholders to implement process improvements and enhance overall efficiency and accuracy.
- Team Collaboration: Collaborate effectively with healthcare providers, nurses, medical assistants, billing staff, and other members of the healthcare team to ensure a smooth and coordinated workflow. Share knowledge, provide training, and offer guidance on prior authorization processes and best practices.
Qualifications and Skills:
- High school diploma or equivalent. (some positions may require an associate's or bachelor's degree in a related field).
- Prior experience in healthcare administration, medical billing, or insurance coordination is highly preferred.
- Strong knowledge of medical terminology, CPT codes, ICD-10 codes, and insurance procedures.
- Familiarity with insurance plans, prior authorization requirements, and reimbursement processes.
- Excellent communication skills, both written and verbal, with the ability to effectively interact with healthcare professionals, insurance companies, and patients.
- Attention to detail and ability to organize and prioritize tasks in a fast-paced environment.
- Strong analytical and problem-solving skills, with the ability to navigate complex insurance processes and resolve issues efficiently.
- Proficiency in using electronic health records (EHR) systems, billing software, and other relevant computer applications.
- Prior Authorization experience required.
