
Senior Prior Authorization Specialist
21 hours ago
We are seeking a highly skilled Prior Authorization Analyst to join our team. This is an exciting opportunity for a seasoned professional to utilize their expertise in authorization and workflow management to drive business growth.
">- Responsibilities:
- Prioritize incoming authorization requests based on urgency and ensure timely completion of tasks.
- Review patient clinical documentation and collaborate with providers' offices to resolve any discrepancies.
- Obtain and follow up on authorization requests from payers through various channels, including outbound calls, online portals, and faxes.
- Respond to payers' clinical questions to facilitate task progression.
- Monitor nurses' activities and provide feedback to improve schedule adherence, accuracy, quality, productivity, timeliness, and compliance with job requirements.
- Deliver required QA monitors on time and maintain accurate records.
- Analyze quality metrics to identify areas for improvement and develop strategies to enhance compliance scores.
- Collaborate with stakeholders to participate in call calibration and identify targets.
- Generate and trend daily/weekly/monthly QA reports to inform business decisions.
- Bachelor of Science in Nursing degree with active PH registered nurse license.
- 1-2 years of US healthcare authorization business experience.
- Strong leadership and interpersonal relationship skills.
- Process management and planning skills.
- Ability to adapt to changing environments and prioritize multiple tasks.
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Prior Authorization Specialist
1 week ago
Pasig, National Capital Region, Philippines Connext Global Solutions Inc Full time $40,000 - $60,000 per yearConnext is a dedicated team of business process outsourcing experts and innovators, with experience in supporting world-class companies in Title and Escrow, Healthcare, Produce Distribution, Retail and Fashion, Design Consulting, and Finance.We are currently looking for a Prior Authorization Specialist who will be working with Connext's Client in the United...
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Prior Authorization PHRN
5 days ago
Pasig, National Capital Region, Philippines Omega Healthcare Management Services Full time ₱45 - ₱55 per yearQualifications:Philippines registered nurse with at least 1 year prior authorization experienceDiagnosis codes (CPT codes, ICD 10 / 11)with signing bonus and competitive salary packageOnsite Ortigas, Pasig City
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Prior-Authorization Nurses USRN
1 week ago
Pasig, National Capital Region, Philippines Visaya Knowledge Process Outsourcing Corporation Full time $40,000 - $60,000 per yearWE'RE HIRING – Prior-Authorization Nurse (PHRN/USRN) – Pioneer Account Location: Ortigas (Onsite) Company: VISAYABe part of a pioneer team supporting patient care through prior-authorization and utilization review services. Qualifications:Graduate of BS Nursing with an active PHRN or USRN licenseAt least 3–5 years of solid experience in:Utilization...
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PHRN - QA (Prior Authorization) ONSITE
1 week ago
Pasig, National Capital Region, Philippines Omega Healthcare Management Services Inc. Full time $40,000 - $80,000 per yearJob Duties and ResponsibilitiesPrioritize incoming authorization and referral requests according to queue urgencyReview patient's clinical and chart documentation related to the service submitted by the provider's officeObtain and/or follow up on authorization and referral requests from the patient's payer/s through any of the following methods—depending...
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PHRN - TL (Prior Authorization) ONSITE
1 week ago
Pasig, National Capital Region, Philippines Omega Healthcare Management Services Inc. Full time $80,000 - $120,000 per yearJob Duties and ResponsibilitiesPrioritize incoming authorization and referral requests according to queue urgencyReview patient's clinical and chart documentation related to the service submitted by the provider's officeObtain and/or follow up on authorization and referral requests from the patient's payer/s through any of the following methods—depending...
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PHRN - QA (Prior Authorization) ONSITE
1 day ago
Pasig, National Capital Region, Philippines Omega Healthcare Management Services Inc. Full timeJob Duties and ResponsibilitiesPrioritize incoming authorization and referral requests according to queue urgencyReview patient's clinical and chart documentation related to the service submitted by the provider's officeObtain and/or follow up on authorization and referral requests from the patient's payer/s through any of the following methods—depending...
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Healthcare Insurance Authorizer
21 hours ago
Pasig, National Capital Region, Philippines beBeeAuthorization Full time ₱550,000 - ₱750,000Insurance Authorization Specialist">We are seeking a highly organized and detail-oriented professional to support our healthcare practice.">This role combines insurance verification and prior authorization duties with patient scheduling, requiring a candidate who can manage both efficiently while delivering exceptional patient service.">Key...
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Pasig, National Capital Region, Philippines Cobden & Carter International Full time $40,000 - $50,000 per yearQualifications:Must have an active PHRN licenseWith at least 1 year experience in Healthcare BPO – prior authorization experience is preferred but not required and/or at least 1-2 years bedside care experience in an acute setting (clinics are not included)Good communication skillsMust be amenable to work ONSITE (Site Location: Ortigas, Pasig)Duties and...
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Pasig, National Capital Region, Philippines Omega Healthcare Management Services Inc. Full time $40,000 - $80,000 per yearJob Duties and ResponsibilitiesPrioritize incoming authorization and referral requests according to queue urgencyReview patient's clinical and chart documentation related to the service submitted by the provider's officeObtain and/or follow up on authorization and referral requests from the patient's payer/s through any of the following methods—depending...
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Healthcare Services Coordinator
21 hours ago
Pasig, National Capital Region, Philippines beBeeAuthorization Full time ₱600,000 - ₱800,000Prior Authorization Specialist Job DescriptionObtaining prior authorizations is a crucial aspect of healthcare services. As a skilled professional, you will be responsible for reviewing and processing all types of prior authorization requests.Key Responsibilities:Review and process prior authorization requests for medical services, procedures, and...