Senior Medical Clearance Specialist

9 hours ago


Province of Palawan, Mimaropa, Philippines beBeeAuthorization Full time ₱800,000 - ₱1,000,000

Prior Authorization Specialist Role

We are seeking a skilled Prior Authorization Specialist to join our team. The successful candidate will be primarily responsible for obtaining all types of prior authorizations, including biologic medications, procedures, prescriptions, and out-patient testing.

Responsibilities:

  • Review and process prior authorization requests for medical services, procedures, and medications
  • Verify insurance (pharmacy) information and eligibility
  • Handle patient inquiries regarding authorizations
  • Provide necessary prior authorization documentation to patients for completion and signature; review all forms for completeness and accuracy
  • Accurately document all patient, pharmacy, and insurance carrier interactions in EMR
  • Coordinate with healthcare providers and insurance companies to obtain necessary authorizations
  • Ensure accurate and timely documentation of authorization requests and approvals
  • Collaborate with medical billing team to resolve any issues or denials
  • Maintain up-to-date knowledge of insurance guidelines and procedures
  • Complete other tasks as assigned by providers through EMR/EHR
  • Copy, fax, and mail documents and information as requested by insurance carrier
  • Schedule follow-up appointments, biologic injections, and photodynamic therapy treatments
  • Assist pathology department with notifying patients of pathology results via telephone
  • 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
  • Provide safe patient-centered, compassionate, and competent patient care


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