Clinical Authorization Coordinator

8 hours ago


Ayala Alabang, National Capital Region, Philippines beBeeAuthorization Full time $55,000 - $75,000

Job Title: Clinical Authorization Coordinator

Clinical Authorization Coordinator Job Description:

The Clinical Authorization Coordinator will be primarily responsible for obtaining all types of prior authorizations, including biologic medications, procedures, prescriptions, and out-patient testing. This role requires professional and courteous interaction with patients, pharmaceutical representatives, providers, pharmacies, and insurance carriers to accurately obtain the required information to process prior authorizations.

Responsibilities Include:

  • Review and process prior authorization requests for medical services, procedures, and medications.
  • Verify patient eligibility and insurance (pharmacy) information
  • Handle patient inquiries regarding authorizations and provide necessary documentation for completion and signature
  • Accurately document all patient, pharmacy, and insurance carrier interactions in electronic medical records (EMR)
  • Coordinate with healthcare providers and insurance companies to obtain necessary authorizations and approvals
  • Ensure timely and accurate 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

Required Skills and Qualifications:

  • Proven 3-5 years of experience as a Prior Authorization Specialist in 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


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