Healthcare Insurance Coverage Specialist

1 day ago


Tarlac City, Central Luzon, Philippines beBeeInsurance Full time ₱13,500

Job Title: Insurance Verification Specialist

This role involves verifying patient insurance coverage and ensuring accuracy and eligibility for proposed healthcare services.

The ideal candidate will have 1 to 3 years of experience in insurance verification and pre-authorization.

Key Responsibilities:

  • Verifying patient insurance coverage, ensuring accuracy and eligibility for proposed healthcare services.
  • Preparing and submitting comprehensive authorization requests to insurance companies with all required documentation.
  • Collaborating with healthcare providers to gather relevant clinical information and facilitate the prior authorization process.
  • Monitoring the status of authorization requests, following up with insurance companies, and maintaining detailed records of communications.
  • Investigating and addressing insurance denials, resubmitting requests and appealing denials when necessary.
  • Communicating with patients to explain the prior authorization process, potential delays, and any financial responsibilities.
  • Ensuring compliance with healthcare regulations, privacy laws, and insurance company policies.

Required Skills and Qualifications:

The successful candidate will possess excellent verbal and written communication skills, strong analytical and problem-solving skills, and a demonstrated ability to accurately perform data entry and pay close attention to detail.

Benefits:

We offer a competitive salary range, paid medical insurance/HMO (Philcare), annual year-end bonus, and monthly bonuses based on performance, as well as opportunities for career development and growth within the organization.



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