Insurance Authorization Specialist

1 day ago


Manila, National Capital Region, Philippines Connext Full time

Connext Global Solutions is a renowned business process outsourcing expert, dedicated to supporting world-class companies in diverse industries.

We are seeking an Insurance Authorization Specialist who will work closely with our client in the United States.

The ideal candidate will be responsible for ensuring timely processing and compliance with insurance requirements for various therapy services.

To achieve this, they will need to possess excellent communication skills, strong organizational abilities, and a deep understanding of insurance policies and medical billing processes.

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.


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