Medical Authorization Coordinator

22 hours ago


Cainta, Calabarzon, Philippines beBeeAuthorization Full time $50,000 - $60,000

We are seeking a highly skilled Prior Authorization Specialist to excel in our team at Bizforce.

Key Responsibilities:
  • Prior Authorization Requests:
  • Obtain all types of prior authorizations, including biologic medications, procedures, prescriptions, and out-patient testing. Ensure accurate and timely documentation for smooth workflow.
  • Interactions with Stakeholders:
  • Communicate professionally and courteously with patients, pharmaceutical representatives, providers, pharmacies, and insurance carriers to gather necessary information.
  • Review and Processing:
  • Analyze and process prior authorization requests for medical services, procedures, and medications, ensuring compliance with insurance guidelines.
  • Insurance Verification:
  • Verify insurance information and eligibility to ensure seamless access to required services.
  • Client Support:
  • Address patient inquiries regarding authorizations and provide necessary documentation for completion and signature.
  • Documentation and Coordination:
  • Accurately document interactions in the Electronic Medical Record (EMR) and collaborate with healthcare providers and insurance companies to obtain necessary authorizations.
  • Quality Assurance:
  • Maintain up-to-date knowledge of insurance guidelines and procedures, ensuring accurate and timely authorization requests and approvals.
  • Collaboration with Billing Team:
  • Work closely with the medical billing team to resolve any issues or denials related to prior authorization requests.

This role requires exceptional communication and interpersonal skills, attention to detail, and the ability to work independently while meeting deadlines.

The ideal candidate will have 3-5 years of experience as a Prior Authorization Specialist in the US Healthcare industry, possessing strong analytical and problem-solving skills.



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