Medical Service Coordinator

2 days ago

Tarlac City, Central Luzon, Philippines beBeeAuthorization Full time $56,000 - $63,000
Job Title:

Prior Authorization Coordinator

  • Manages prior authorization requests for medical services, procedures, and medications.
Key Responsibilities:
  1. Request Processing: Reviews and processes prior authorization requests in a timely manner to ensure minimal delays in patient care.
  2. Verification: Verifies insurance information and eligibility for patients to ensure accurate billing and processing.
  3. Patient Communication: Communicates with patients regarding their prior authorization status and provides necessary documentation for completion and signature.
  4. Documentation: Accurately documents all patient, pharmacy, and insurance carrier interactions in the electronic medical record (EMR).
  5. Collaboration: Coordinates with healthcare providers and insurance companies to obtain necessary authorizations and resolve any issues or denials.
  6. Compliance: Ensures accurate and timely documentation of authorization requests and approvals to maintain compliance with regulatory requirements.
  7. Troubleshooting: Collaborates with the medical billing team to resolve any issues or denials related to prior authorizations.
Requirements:
  • Proven 3-5 years of experience as a Prior Authorization Specialist in the US Healthcare industry.
  • Insurance Knowledge: Strong knowledge of insurance verification processes and payer/billing guidelines.
  • Communication Skills: Excellent communication and interpersonal skills to work effectively with patients, providers, and insurers.
  • Organizational Skills: Detail-oriented with strong organizational skills to manage multiple tasks and deadlines.
  • Independence: Ability to work independently and make decisions with minimal supervision.
  • Flexibility: Comfortable working in a remote, work-from-home setup and willing to work varying shifts, including graveyard shifts.

The ideal candidate will have a strong understanding of insurance policies and procedures, excellent communication skills, and the ability to work independently and meet deadlines.

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