Prior Authorization Consultant

4 days ago


Mandaluyong City, National Capital Region, Philippines Vector Outsourcing Solutions Philippines Full time

Salary: 30,000 PHP - 35,000/month

Job Description:

  • Receive requests for prior authorizations using the Scheduling module of the Electronic Health Record (EHR) and/or via phone or fax and ensure that they are closely monitored.
  • Process referrals and submit medical records to insurance carriers to expedite prior authorization processes.
  • Review the patient's medical history and insurance coverage for approval.
  • Manage correspondence with insurance companies, physicians, specialists, and patients as needed, including documenting in the EHR as appropriate.
  • Assist with the necessary documentation to expedite approvals and ensure that appropriate follow-up is performed.
  • Review the accuracy and completeness of the information requested and ensure that all supporting documents are present.

Minimum Qualifications:

  • Graduate of Bachelor's Degree (preferably in Medical, but not required)
  • Consultancy basis minimum of 6 months consultancy contract (subject for renewal)
  • At least 1 year of background with Prior Authorization under a BPO healthcare account is an advantage
  • Must have excellent English communication skills, both written and oral
  • Ability to prioritize and organize multiple tasks
  • Willing to work in shifting schedules, mostly night shift
  • Able to work from home, must have a reliable internet connection

Others:

  • Equipment/company computer is provided
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