Prior Authorization Coordinator

1 day ago

Cebu City, Central Visayas, Philippines beBeeAuthorization Full time $64,000 - $84,000

Job Title:

Prior Authorization Coordinator

About the Role:

We are seeking a skilled and detail-oriented Prior Authorization Specialist to join our team. As a Prior Authorization Specialist, you will be responsible for reviewing and processing prior authorization requests for medical services, procedures, and medications.

Responsibilities:

  1. Review and process prior authorization requests for medical services, procedures, and medications.
  2. Verify insurance information and eligibility.
  3. Handle patient inquiries regarding authorizations.
  4. Provide necessary prior authorization documentation to patients for completion and signature. Review all forms for completeness and accuracy.
  5. Accurately document all patient, pharmacy and insurance carrier interactions in an Electronic Medical Record (EMR).
  6. Coordinate with healthcare providers and insurance companies to obtain necessary authorizations.
  7. Ensure accurate and timely documentation of authorization requests and approvals.
  8. Collaborate with medical billing team to resolve any issues or denials.
  9. Maintain up-to-date knowledge of insurance guidelines and procedures.
  10. Complete other tasks as assigned by providers through EMR/EHR.
  11. Copy, fax and mail documents and information as requested by insurance carrier.
  12. Schedule follow-up appointments, biologic injections and photodynamic therapy treatments.
  13. Assist pathology department with notifying patients of pathology results via telephone.
  14. Fulfill organizational responsibilities as assigned, which may include but are not limited to: respecting and promoting patient's rights, responding appropriately to emergency situations, sharing problems relating to patients and/or staff with Care Center Leader in a timely manner.
  15. Provide safe patient-centered, compassionate, and competent patient care.

Requirements:

  • Proven 3-5 years of experience as a Prior Authorization Specialist in the US Healthcare.
    • Strong knowledge of insurance verification processes and payer/billing guidelines.
    • Excellent communication and interpersonal skills to work effectively with patients, providers, and insurers.
    • Detail-oriented with strong organizational skills.
    • Ability to work independently and meet deadlines.
    • Comfortable working in a remote, work-from-home setup.
    • Amenable to work in a graveyard shift.

System Requirements:

  • Device (Desktop or Laptop)
  1. Processor:
  • Windows Devices: Intel Core i5 (or higher) or AMD Ryzen 5 (or higher).
  • Mac Devices: Apple M1 chip or newer.
RAM:
  • Minimum of 8GB or higher for optimal performance.
Operating System:
  • Windows: Windows 11 Pro (Windows 10 Pro is acceptable but not preferred). The operating system must have a legitimate license.
  • Mac: macOS compatible with M1 or newer chips.
Hard Disk:
  • At least an SSD for faster processing and performance.
Internet Connectivity:
  • Minimum speed of 50 Mbps via a wired connection for stability and reliability.
  • A backup internet connection is highly recommended.
Power Supply:
  • A backup power supply (e.g., UPS or generator) to prevent disruptions during power outages (optional but encouraged)

  • Prior Authorization Professional

    1 day ago

    Cebu City, Central Visayas, Philippines beBeeInsurance Full time ₱600,000 - ₱800,000

    Prior Authorization Specialist OpportunityOur organization seeks a meticulous Prior Authorization Specialist to support their busy endocrinology practice. This role combines insurance verification and prior authorization duties with patient scheduling, requiring efficient management while delivering exceptional patient service.Key Responsibilities:Verify...

  • Prior Authorization Specialist

    7 days ago

    Cebu City, Central Visayas, Philippines Hirebiz Inc. Full time $104,000 - $130,878 per year

    We're looking for a detail-oriented and experienced Prior Authorization Specialist to join our growing team. In this role, you will be responsible for handling pre-certifications, verifying insurance coverage, and ensuring timely approvals for medical procedures, medications, and services. Your work will directly support patients in accessing the care they...

  • Healthcare Prior Authorizations Coordinator

    1 day ago

    Iloilo City, Western Visayas, Philippines beBeeAuthorization Full time ₱17,924 - ₱25,148

    Are you seeking a rewarding and challenging career in healthcare?Prior Authorization Specialist RoleWe are currently looking for a skilled Prior Authorization Specialist to join our team. This role involves obtaining all types of prior authorizations, including biologic medications, procedures, prescriptions, and out-patient testing.Review and process prior...

  • Prior Authorization Specialist

    1 day ago

    Iloilo City, Western Visayas, Philippines beBeePriorAuthorization Full time ₱800,000 - ₱1,000,000

    Job Title: Prior Authorization SpecialistWe are seeking a highly skilled and detail-oriented professional to support our busy Endocrinology practice in Prior Authorization and Scheduling. This role requires efficient management of insurance verification, prior authorizations, and patient scheduling, while delivering exceptional patient service.Key...

  • Authorization Coordinator

    1 day ago

    Angeles City, Central Luzon, Philippines beBeeAuthorization Full time $60,000 - $72,000

    Job Overview:The Prior Authorization Specialist position is responsible for ensuring seamless prior authorization processes, encompassing a range of tasks including biologic medication, procedures, and outpatient testing.This role requires effective communication and collaboration with patients, pharmaceutical representatives, healthcare providers,...

  • Senior Healthcare Authorization Coordinator

    1 day ago

    Mandaue City, Central Visayas, Philippines beBeeAuthorization Full time $50,000 - $70,000

    Job Opportunity:We are seeking a skilled Prior Authorization Specialist to support our healthcare division.The Prior Authorization Specialist will be responsible for obtaining all types of prior authorizations, including biologic medications, procedures, prescriptions and out-patient testing.Key Responsibilities:Review and process prior authorization...

  • Authorization Specialist – Endocrinology

    1 day ago

    Mandaue City, Central Visayas, Philippines beBeeMedication Full time ₱3,000,000 - ₱4,250,000

    As a Medication Authorization Coordinator, you will play a vital role in supporting our Endocrinology practice by verifying insurance coverage and obtaining prior authorizations for medications, diagnostic tests, and procedures. You will also be responsible for accurately scheduling patient appointments, follow-ups, and procedures in coordination with the...

  • Patient Authorization Coordinator

    2 weeks ago

    Angeles City, Central Luzon, Philippines SuperStaff Full time

    The Patient Authorization Coordinator is the employee that interacts and works closely with many others employees. This person also interacts with the clinical sales specialists, physicians, nurses, office staff, case managers for all manufacturers, and the patient/patient family. This position is at the corporate office. The Patient Authorization...

  • Administrative Coordinator

    1 day ago

    Cebu City, Central Visayas, Philippines beBeeAdministrative Full time ₱48,000 - ₱63,500

    We are seeking a highly skilled Administrative Coordinator to provide exceptional support to our publishing company.Key Responsibilities:Email Management: Respond promptly and professionally to all emails, ensuring timely and accurate communication with authors, stakeholders, and clients.Website Updates: Update the company website with book details,...

  • Medical Authorization Specialist

    1 day ago

    Angeles City, Central Luzon, Philippines beBeeAuthorization Full time $36,000 - $54,000

    Job Title: Medical Authorization SpecialistWe are seeking a highly skilled and detail-oriented professional to join our team as a Medical Authorization Specialist. This role requires strong communication and organizational skills, with the ability to manage multiple tasks efficiently.About the Role:Verify insurance coverage and obtain prior authorizations...