Medical Prior Authorization Specialist

2 months ago


Davao City, Davao, Philippines Med Supply US Full time

Med Supply US is seeking a highly skilled Medical Prior Authorization Specialist to join our team. This role plays a vital part in ensuring that medical services, procedures, and medications are approved by insurance companies before they are rendered or prescribed.

Key Responsibilities:
  • Prioritize and manage prior authorization requests, gathering all necessary information and documentation from healthcare providers and patients.
  • Verify patient insurance coverage, including benefits, eligibility, and limitations, to ensure accurate billing and reimbursement.
  • Maintain accurate records of authorization requests, follow-up activities, and outcomes, communicating with stakeholders as needed.
  • Stay up-to-date with industry regulations, policies, and guidelines related to prior authorizations, ensuring compliance with legal requirements.
  • Analyze denials and identify trends to minimize future denials, implementing process improvements to enhance efficiency and accuracy.

To succeed in this role, you will require strong analytical and problem-solving skills, excellent communication skills, and the ability to work effectively in a fast-paced environment.

Requirements:
  • Bachelor's degree in a related field (healthcare administration, medical billing, or insurance coordination)
  • Minimum 2 years of experience in prior authorization or a related field
  • Knowledge of medical terminology, CPT codes, ICD-10 codes, and insurance procedures
  • Proficiency in electronic health records (EHR) systems and relevant computer applications

The estimated annual salary for this position is $65,000-$85,000, depending on location and experience.



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