Healthcare Authorization Coordinator

2 days ago

Cabuyao, Calabarzon, Philippines beBeeAuthorization Full time $60,520 - $75,105
Prior Authorization Specialist Role

Delivering high-quality prior authorizations to the US healthcare industry.

Job Description:

The Prior Authorization Specialist will be primarily responsible for obtaining all types of prior authorizations, including biologic medications, procedures, prescriptions, and out-patient testing. The position 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:
  1. Review and process prior authorization requests for medical services, procedures, and medications.
  2. Verify insurance (pharmacy) information and eligibility.
  3. Handle patient inquiries regarding authorizations.
  4. Provide necessary prior authorization documentation to patients for completion and signature. Review all forms for completeness and accuracy.
  5. Accurately document all patient, pharmacy, and insurance carrier interactions in EMR.
  6. Coordinate with healthcare providers and insurance companies to obtain necessary authorizations.
  7. Ensure accurate and timely documentation of authorization requests and approvals.
  8. Collaborate with medical billing team to resolve any issues or denials.
  9. Maintain up-to-date knowledge of insurance guidelines and procedures.
  10. Complete other tasks as assigned by providers through EMR/EHR.
  11. Copy, fax, and mail documents and information as requested by insurance carrier.
  12. Schedule follow-up appointments, biologic injections, and photodynamic therapy treatments.
  13. Assist pathology department with notifying patients of pathology results via telephone.
  14. Provide safe patient-centered, compassionate, and competent patient care.

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