Medical Authorization Coordinator

1 week ago


Hagonoy, Central Luzon, Philippines beBeePriorAuthorization Full time $60,000 - $82,500

Prior Authorization Specialist Role

We are seeking a skilled Prior Authorization Specialist to obtain prior authorizations for medical services, procedures, and medications. The ideal candidate will have excellent communication and interpersonal skills to work effectively with patients, providers, and insurers.

Responsibilities:

  • Review and process prior authorization requests for medical services, procedures, and medications
  • Verify insurance information and eligibility
  • Handle patient inquiries regarding authorizations
  • Provide necessary prior authorization documentation to patients for completion and signature. Review all forms for completeness and accuracy.
  • Accurately document all patient, pharmacy, and insurance carrier interactions in EMR.
  • Coordinate with healthcare providers and insurance companies to obtain necessary authorizations
  • Ensure accurate and timely documentation of authorization requests and approvals
  • Collaborate with medical billing team to resolve any issues or denials
  • Maintain up-to-date knowledge of insurance guidelines and procedures
  • Complete other tasks as assigned by providers through EMR/EHR
  • Copy, fax, and mail documents and information as requested by insurance carrier
  • Schedule follow-up appointments, biologic injections, and photodynamic therapy treatments
  • Assist pathology department with notifying patients of pathology results via telephone
  • Fulfill organizational responsibilities as assigned, which may include but are not limited to: respecting and promoting patient's rights, responding appropriately to emergency situations, sharing problems relating to patients and/or staff with Care Center Leader in a timely manner
  • Provide safe patient-centered, compassionate, and competent patient care.

Requirements:

  • Proven 3-5 years of experience as a Prior Authorization Specialist in the US Healthcare
  • Strong knowledge of insurance verification processes and payer/billing guidelines.
  • Excellent communication and interpersonal skills to work effectively with patients, providers, and insurers.
  • Detail-oriented with strong organizational skills
  • Ability to work independently and meet deadlines
  • Comfortable working in a remote, work-from-home setup
  • Amenable to work in a graveyard shift

System Requirements:

  • Device (Desktop or Laptop)
  • Processor: Windows Devices - Intel Core i5 (or higher) or AMD Ryzen 5 (or higher); Mac Devices - Apple M1 chip or newer
  • RAM: Minimum of 8GB or higher for optimal performance
  • Operating System: Windows - Windows 11 Pro; Mac - macOS compatible with M1 or newer chips
  • Hard Disk: At least an SSD for faster processing and performance
  • Internet Connectivity: Minimum speed of 50 Mbps via a wired connection for stability and reliability
  • Backup internet connection highly recommended


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