PHRN - AR Executive (Prior Authorization) SOB 40K

2 weeks ago


Cebu City, Central Visayas, Philippines Omega Healthcare Management Services Inc. Full time

Job Duties and Responsibilities

  1. Prioritize incoming authorization and referral requests according to queue urgency
  2. Review patient's clinical and chart documentation related to the service submitted by the provider's office
  3. Obtain and/or follow up on authorization and referral requests from the patient's payer/s through any of the following methods—depending on the payer's policy:
    1. Perform outbound calls to payer's authorization department
    2. Access payer's authorization online portal
    3. Submit faxes to payer's authorization department
  4. Respond to payer's clinical questions to be able to proceed with the authorization and referral requests
  5. Obtain and/or follow up payer's peer-to-peer review requirements and send them back to provider's office for the actual initiation
  6. Cater inbound calls from payers and perform necessary actions required for the task
  7. Listen and review voicemail messages from payers then perform necessary actions required for the task

Required Skills

  1. Solid understanding of anatomy & physiology, including how body systems function and an understanding of disease processes
  2. Comprehensive understanding of Medical Terminology
  3. Prior experience in processing multispecialty authorizations including contact with payers
  4. 2 years experience of acute hospital experience
  5. Experience in prior authorization process
  6. Experience with general computer software (Internet, Word, Outlook, PDF required)
  7. Proficiency to learn new software programs quickly
  8. Excellent customer service skills: communicates clearly and effectively
  9. Excellent verbal and written communication skills
  10. Professional and effective interaction skills with co-workers, clients, providers, and vendors
  11. Proven ability to work well individually and as a team member
  12. Strong attention to detail
  13. Ability to follow company and account-specific standard operating procedures and policies
  14. Ability to adapt to constantly changing environment
  15. Ability to prioritize and organize multiple tasks by remaining focused and quality-driven at all tasks at hand
  16. Ability to remain organized with multiple interruptions
  17. Ability to make decisions independently without bypassing any company and account-specific standard operating procedures and policies
  18. Ability to comfortably receive constructive feedback

Required Experience

  1. Graduate of Bachelor of Science in Nursing with active PH registered nurse license
  2. 1–2 years of experience in business process outsourcing preferably
  3. 1–2 years of experience of US healthcare authorization business
#J-18808-Ljbffr

  • Cebu City, Central Visayas, Philippines Med Supply US Full time

    Medical Prior Authorization-Insurance Verification SpecialistPosition Summary: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...


  • Cebu City, Central Visayas, Philippines Tahche Careers Full time

    Our US partner is one of the leading Medical Digital Imaging Service Providers in New Jersey. They offer a full spectrum of diagnostic imaging services in comfortable, convenient, and friendly outpatient imaging centers.As a Prior Authorization Specialist, you are responsible for obtaining pre-certifications and pre-authorizations for procedures and...

  • Graphic Artist

    2 weeks ago


    Cebu City, Central Visayas, Philippines AR Fabriquer Full time

    On-site - Cebu 1-3 Yrs Exp Bachelor Full-timeJob DescriptionA Graphic Artist creates visual concepts using computer software or by hand to communicate ideas that inspire, inform, or captivate consumers. They design layouts for advertisements, websites, logos, and other marketing materials, ensuring the visuals align with the brand's...


  • Cebu City, Central Visayas, Philippines Staff Outsourcing Solutions Full time

    We are looking for a skilled Medical Billing Specialist to start ASAP in Cebu City. As a representative of insurance providers or members lines, you will handle queries related to eligibility, benefits, claims, and authorizations.Requirements include experience working in inpatient or outpatient services, knowledge of basic insurance terms, and proficiency...


  • Cebu City, Central Visayas, Philippines Staff Outsourcing Solutions Full time

    Staff Outsourcing Solutions is seeking a skilled Claims Analyst to join our team. As a representative of insurance providers or members lines, you will handle queries related to eligibility, benefits, claims, and authorizations.The ideal candidate will have experience working in inpatient or outpatient services, with a solid understanding of basic insurance...


  • Cebu City, Central Visayas, Philippines Staff Outsourcing Solutions Full time

    At Staff Outsourcing Solutions, we are seeking a highly skilled Insurance and Claims Professional to join our team. This is an exciting opportunity to work as a representative of insurance providers or members lines, handling queries related to eligibility, benefits, claims, and authorizations.The ideal candidate will have experience working in inpatient or...


  • Cebu City, Central Visayas, Philippines NCR Atleos Full time

    About the RoleNCR Atleos, a leader in expanding financial access, seeks a skilled AR Collection Analyst to execute credit/collections processing and manage credit practices within the company's accounting function.Key ResponsibilitiesManage all aspects of credit extension and collection for a specific portfolio of customers.Confer with customers to determine...


  • Cebu City, Central Visayas, Philippines Icon Executive Asia Full time

    Oversees and manages the day-to-day overall accounting and financial activities ensuring proper controls, compliance and accuracy to guide management in making business decisions. Develops and maintains accounting principles, practices and procedures to ensure accurate and timely financial statements.Compliance and Risk Management: (Accounting Policies and...


  • Cebu City, Central Visayas, Philippines Staff Outsourcing Solutions Full time

    Job OverviewWe are seeking an experienced Insurance Claims Analyst to join our team at Staff Outsourcing Solutions. As an Insurance Claims Analyst, you will be responsible for following up with insurance carriers to determine the reason for claims denial and work to resolve medical claims for payment.Key Responsibilities:Research problem accounts to ensure...

  • Sales Executive

    5 days ago


    Cebu City, Central Visayas, Philippines Sakura Autoworld Inc. - Suzuki Auto Head Office Full time

    SAKURA AUTOWORLD, INC.Sakura Autoworld Inc. commenced operations on July 1, 2012, and is the largest authorized dealer of Suzuki automobiles in the Philippines. We have branches located in Sucat (Paranaque), Naga (Camarines Sur), Legazpi, Calbayog, Tacloban, Ormoc, Cebu, Dumaguete, Iloilo, Kalibo, Roxas, Antique, and Surigao.SALES EXECUTIVEThe Sales...


  • Cebu City, Central Visayas, Philippines NCR Atleos Full time

    Location field must contain 'city, state' or a zip code to perform a radius search (e.g., Denver, CO or 46122 ). City and state must be separated by a comma followed by a space (e.g., Houston, TX )NCR Atleos AR Collection Analyst in CEBU CITY, PhilippinesAbout NCR AtleosNCR Atleos, headquartered in Atlanta, is a leader in expanding financial access. Our...


  • Angeles City, Central Luzon, Philippines Clark Outsourcing Full time

    Career Opportunities at Clark Outsourcing - A World of Possibilities.About the Role:The AR Assistant will provide critical support to our finance team, focusing on accounts receivable management, data analysis, and administrative tasks.Main Responsibilities:Process and manage customer invoices on client portalsIdentify and resolve invoice submission errors...


  • Cebu City, Central Visayas, Philippines Staff Outsourcing Solutions Full time

    RequirementsExperience working as a representative of the providers or members line for queries in eligibility and benefits, claims, and authorizations.Preferably with experience in inpatient or outpatient services.Must know the basic insurance terms.Knowledge in Medical Billing/Claims.Experience in Revenue Cycle Management (or a part of) required.The job...


  • Cebu City, Central Visayas, Philippines CallTek Full time

    About CallTekWe are a dynamic company looking for a highly skilled Executive Assistant to join our team. The successful candidate will provide exceptional support to our CEO, contributing to the company's growth and success.Job Description:The Executive Assistant will be responsible for a range of administrative tasks, including drafting correspondence,...


  • Cebu City, Central Visayas, Philippines NCR Atleos Full time

    Job DescriptionNCR Atleos, a leading financial services company, is seeking an AR Collection Analyst to join their team. As a key member of the accounting function, the successful candidate will be responsible for executing credit/collections processing and managing credit practices.Responsibilities:


  • Cebu City, Central Visayas, Philippines Icon Executive Asia Full time

    Experiences1. At least three (3) years of work-related experience in a Supervisory capacity.2. At least a graduate of Bachelor's degree in Business Administration, Psychology, Behavioral Science, Human Resource Management or any related field.CertificationsN/AOther Basic Requirements1. With strong analytical skills.2. With excellent communication and...


  • Cebu City, Central Visayas, Philippines Easybook Full time

    Scope of Role:The Business Development Executive reports directly to the Business Development Director.He/She will be responsible for leading Easybook.com's expansion strategy and partnership growth of land and sea operators in the southern provinces of the Philippines.Job Description:Engage, grow and retain a solid partnership base of Bus & Ferry Operators,...


  • Cebu City, Central Visayas, Philippines Arcanys Full time

    Arcanys is looking for an Executive Sales Specialist to manage a portfolio of Australian-based clients who use our platforms for cash flow and travel expense offsetting.Your primary goal will be to maintain and grow your existing client base while effectively cross-selling additional products via phone and email communication.You will be responsible for...


  • Cebu City, Central Visayas, Philippines CallTek Full time

    ResponsibilitiesCollections' Agent will conduct outbound collection calls in a professional manner to maintain customer relationships.Instructs customers how to process payments via the company's online portal.Provides daily, weekly tracking reports & metrics on outstanding AR.Documents collection activity within company collections module and Microsoft...


  • Cebu City, Central Visayas, Philippines KMC Solutions Full time

    Make your next big career move by applying as KMC Solutions' next CUSTOMER SERVICE REPRESENTATIVE IMedImpact was established over three decades ago by a pharmacist and independent drug store owner who witnessed the struggles families faced with high prescription costs. Committed to making prescription benefits more accessible and understandable, MedImpact...