Clinical Authorization Specialist

4 days ago

Manila, National Capital Region, Philippines LKN Strategies Inc Full time ₱384,000 - ₱456,000 per year

Clinical Authorization Specialist

Company Profile

LKN Strategies is an established healthcare BPO provider with locations in the US, Philippines, and India. LKN is an employee-centric company that offers its employees competitive salaries, robust benefits packages, incentive bonuses, best-in-industry training, professional development, work-from-home positions, and growth opportunities.

Job Qualifications:

  • 1-2 years of proven work experience as a Clinical Authorization Specialist in the healthcare industry.
  • Registered Nurse required with experience in reviewing medical records and charts in U.S. Healthcare.
  • Excellent written and spoken English
  • Unflinching integrity and personal work ethics
  • Self-starter who strives for self and team excellence
  • Flair for client satisfaction
  • Attention to detail and concern for accuracy
  • Excellent time management skills and multi-tasking ability
  • Excellent team player
  • Compliant to rules and regulations

Job Description

Duties and Responsibilities:

  • Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations.
  • Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed.
  • Review denials and follow up with provider to obtain medically necessary information to submit an appeal of the denial.
  • Prioritize the incoming authorizations by level of urgency to the patient.
  • Manage correspondence with insurance companies, physicians, specialists, and patients as needed, including documenting in the EHR as appropriate.
  • Respond to clinical questions regarding payer medical policy guidelines.

Job Type: Full-time

Pay: Php30, Php38,000.00 per month

Benefits:

  • Paid training
  • Work from home

Experience:

  • Clinical Authorization Specialist: 1 year (Required)

Language:

  • English (Required)

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