Medical Clearance Specialist

5 days ago


Manila, National Capital Region, Philippines Connext Full time

As a Medical Clearance Specialist at Connext Global Solutions, you will play a crucial role in ensuring timely processing and compliance with insurance requirements for various therapy services.

Key Responsibilities:

  • Verify patient eligibility and benefits across multiple payers, states, and insurance products.
  • Work closely with providers to collect accurate patient and medical records.
  • Communicate authorization decisions and ensure approval in a timely manner by following up with insurers.

Requirements:

  • Minimum of one year of experience in medical billing and/or understanding of benefits.
  • Strong understanding of insurance policies and medical billing processes including CPT coding.
  • Familiarity with provider software, including Electronic Medical Record Systems (EMR/EHR) and Practice Management Systems (PMS).
  • Experienced with HMOs, PPOs, POSs, EPOs, Medicare, Medicaid, and understanding of each through the referral and authorization process.

Screening Criteria:

  • Work Set-up: ONSITE (Ortigas)
  • Must have a stable employment history.


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