Current jobs related to Medical Prior Authorization - Manila - Med Supply US

  • Prior Authorization Specialist

    5 days ago

    Manila, National Capital Region, Philippines Connext Full time

    Connext Global Solutions is a dedicated team of business process outsourcing experts and innovators, with experience in supporting world-class companies in Title and Escrow, Healthcare, Produce Distribution, Retail and Fashion, Design Consulting, and Finance.We are currently looking for a Prior Authorization Specialist who will be working with Connext's...

  • Healthcare Prior Authorization Specialist

    2 days ago

    Manila, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time

    Are you a detail-oriented individual looking for a challenging role in a BPO healthcare setting? As a Medical Allied Professional at Access Healthcare Services Manila, Inc., you will play a key role in ensuring the timely and accurate processing of prior authorization requests for medical procedures and treatments.Job Description:This role involves reviewing...

  • Prior Authorization Representative

    1 day ago

    Manila, National Capital Region, Philippines MED-METRIX INTERNATIONAL PH-I, INC. Full time

    Experience these Xtraordinary benefits when you join Med-Metrix8-Hour Shifts, Fixed Weekends OffDay 1 HMO with 2 of your dependents covered for FREEMedical Cash AllowanceRice AllowanceClothing AllowanceFree Lunch DailyPaid Time OffTraining and Staff DevelopmentEmployee Engagement ActivitiesOpportunities for Internal MobilityThe Prior Authorization...

  • Prior Authorization Specialist

    3 days ago

    Manila, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time

    Access Healthcare Services Manila, Inc. is looking for a skilled Prior Authorization Specialist to join their team.Key Responsibilities:The ideal candidate will review and process prior authorization requests from healthcare providers.They will verify patient insurance coverage and ensure compliance with payer requirements.Coordinating with healthcare...

  • Medical Authorizer

    3 days ago

    Manila, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time

    Access Healthcare Services Manila, Inc. is looking for a skilled Medical Authorizer to join their team.About the Role:The successful candidate will be responsible for reviewing and processing prior authorization requests from healthcare providers.This role involves verifying patient insurance coverage and ensuring compliance with payer requirements.The...

  • Medical Authorization Specialist

    1 day ago

    Manila, National Capital Region, Philippines MED-METRIX INTERNATIONAL PH-I, INC. Full time

    Job DescriptionWe are seeking a highly skilled Medical Authorization Specialist to join our team at Med-Metrix International PH-I, Inc. As a key member of our organization, you will play a vital role in ensuring seamless communication with insurance companies to obtain pre-certifications and authorizations for medical services.In this dynamic position, you...

  • Prior Approval Coordinator

    5 days ago

    Manila, National Capital Region, Philippines Connext Full time

    We are currently looking for a skilled Prior Approval Coordinator who will join our team at Connext Global Solutions.This role requires a knowledgeable and organized individual with excellent communication skills to ensure timely processing and compliance with insurance requirements for therapy services.Key Responsibilities:Verify patient eligibility and...

  • Medical Allied Graduates

    2 days ago

    Manila, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time

    Access Healthcare is looking for motivated and detail-oriented individuals to join our Healthcare Prior Authorization team. This role is ideal for Fresh Graduates with a Medical Allied degree who possess excellent communication skills and are eager to build their careers in a BPO healthcare setting. The successful candidates will play a key role in ensuring...

  • Medical Authorization Specialist

    5 days ago

    Manila, National Capital Region, Philippines Med-Metrix Full time

    At Med-Metrix, we offer a unique opportunity to work with our dynamic team and make a meaningful impact in the healthcare industry.Job OverviewThis role is responsible for obtaining and providing accurate and complete data input for precertification/preauthorization from insurance companies.The ideal candidate will have extensive knowledge of individual...

  • Insurance Authorization Specialist

    5 days ago

    Manila, National Capital Region, Philippines Connext Full time

    Connext Global Solutions is a renowned business process outsourcing expert, dedicated to supporting world-class companies in diverse industries.We are seeking an Insurance Authorization Specialist who will work closely with our client in the United States.The ideal candidate will be responsible for ensuring timely processing and compliance with insurance...

  • Medical Laboratory Specialist

    4 days ago

    Manila, National Capital Region, Philippines Supercare Medical Services Inc. Full time

    Job Summary:We are seeking a skilled Medical Laboratory Specialist to join our team at Supercare Medical Services Inc. This is an exciting opportunity for individuals who are passionate about delivering high-quality laboratory services.The successful candidate will be responsible for instructing and preparing examinees for different specimen collection...

  • Authorization Representative

    5 days ago

    Manila, National Capital Region, Philippines Med-Metrix Full time

    On-site - Manila 3-5 Yrs Exp Diploma Full-timeJob DescriptionJoin our dynamic team and make a meaningful impact in the healthcare industry. Enjoy competitive benefits upon hire, ongoing professional development, and the satisfaction of helping others every day. Take the next step in your career with Med-MetrixExperience these exceptional benefits when you...

  • Medical Allied Professionals

    2 days ago

    Manila, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time

    At Access Healthcare Services Manila, Inc., we are seeking highly motivated and detail-oriented individuals to join our dynamic team as Medical Allied Professionals. This role is ideal for fresh graduates with a medical allied degree who possess excellent communication skills and a passion for building their careers in a BPO healthcare setting.Key...

  • Medical Authorization Expert

    2 days ago

    Manila, National Capital Region, Philippines Cognizant Technology Solutions Philippines Inc. Full time

    What You'll Be Doing:As a Pharmacy Support Professional, you will be responsible for providing clinical support to healthcare facilities and insurance companies. This includes coordinating preauthorizations, managing documentation, and following up on authorization requests.Responsibilities:Coordination with Billing Teams:• Deliver all preauthorization...

  • Clinical Task Coordinator

    7 days ago

    Manila, National Capital Region, Philippines CF Solutions Philippines Inc. Full time

    Position SummaryThe Clinical Task Coordinator (CTC) plays a crucial role in streamlining communication and coordination across various departments in a healthcare setting. They manage clinical tasks through the EHR system, oversee medication prior authorizations, and handle patient phone calls or inquiries, directing them to the appropriate staff. This role...

  • Medical Claims Examiner

    6 days ago

    Manila, National Capital Region, Philippines Nezda Technologies, Inc. Full time

    About the Role">The Medical Claims Examiner position at Nezda Technologies, Inc. involves reviewing medical reports, job responsibilities, and insurance policies to determine eligibility for short-term and long-term disability benefits.">Key Responsibilities">Evaluate medical records, job roles, and insurance contracts to assess suitability for disability...

  • SAP Authorization Consultant

    2 days ago

    Manila, National Capital Region, Philippines NNIT Digital & Life Sciences Philippines Inc. Full time

    About the Role/ProjectWe are seeking a highly skilled and experienced Senior SAP Authorization Consultant to join our dynamic SAP Security and Authorization team. This individual will play a key role in managing SAP user roles, authorizations, and security policies across various SAP systems, ensuring that the organization's SAP environment is secure,...

  • Medical Technologists

    5 days ago

    Manila, National Capital Region, Philippines Supercare Medical Services Inc. Full time

    Job summary:Looking for candidates available to work:Monday: Morning, AfternoonTuesday: Morning, AfternoonWednesday: Morning, AfternoonThursday: Morning, AfternoonFriday: Morning, AfternoonSaturday: MorningNo experience required for this roleWorking rights required for this roleImmediate start availableQUALIFICATIONS:With valid PRC license in Medical...

  • Medical Biller

    2 days ago

    Manila, National Capital Region, Philippines KMC Solutions Full time

    Grow with us in the heart of Metro Manila This position is an onsite independent contractor role, based in Ortigas CBD, Pasig, right by Ortigas Station MRT.ESSENTIAL JOB FUNCTIONS:Medical Billing & Claims Processing:Prepare and submit clean claims to insurance companies via electronic and paper submissions.Verify patient insurance eligibility and benefits...

  • Medical Clearance Specialist

    5 days ago

    Manila, National Capital Region, Philippines Connext Full time

    As a Medical Clearance Specialist at Connext Global Solutions, you will play a crucial role in ensuring timely processing and compliance with insurance requirements for various therapy services.Key Responsibilities:Verify patient eligibility and benefits across multiple payers, states, and insurance products.Work closely with providers to collect accurate...

Medical Prior Authorization

1 month ago

Manila, Philippines Med Supply US Full time ₱25,000 - ₱30,000
Medical Prior Authorization-Insurance Verification Specialist

Position 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 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.
  • Note: The above job description provides a general overview of the responsibilities and requirements for a Prior Authorization Specialist. Actual job duties may vary depending on the specific healthcare setting, organizational policies, and regional regulations.
  • Prior Authorization experience required.