Healthcare Prior Authorization Professional

2 hours ago

Pulong Santa Cruz, Calabarzon, Philippines beBeeAuthorization Full time ₱2,000,000 - ₱3,000,000

Job Title: Prior Authorization Specialist

Job Description:

  • The primary responsibility of the Prior Authorization Specialist is to obtain prior authorizations for various medical services, including procedures, prescriptions, and out-patient testing.
  • Key responsibilities include reviewing and processing prior authorization requests, verifying patient insurance information and eligibility, responding to patient inquiries regarding authorizations, and providing necessary documentation to patients for completion and signature.
  • Additional tasks may include accurately documenting all patient, pharmacy, and insurance carrier interactions in the Electronic Medical Record (EMR), coordinating with healthcare providers and insurance companies to obtain necessary authorizations, ensuring timely and accurate documentation of authorization requests and approvals, collaborating with the medical billing team to resolve any issues or denials, maintaining up-to-date knowledge of insurance guidelines and procedures, and completing other tasks as assigned by healthcare providers through EMR/EHR.
  • The ideal candidate must possess excellent communication and interpersonal skills to work effectively with patients, providers, and insurers, and be detail-oriented with strong organizational skills. The Prior Authorization Specialist must also be able to work independently, meet deadlines, and be comfortable working in a remote environment.

Requirements:

  • A minimum of 3-5 years of experience as a Prior Authorization Specialist in the US Healthcare industry
  • 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 environment

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