PHRN – Prior Authorization

#Hiring: Prior Authorization SpecialistJoin us at Uplift Healthcare SolutionsWe are seeking a detail-oriented and highly organized Prior Authorization Specialist to join our healthcare team. The ideal candidate will be responsible for obtaining and managing prior authorizations for medical procedures, medications, and services. This role requires...

Responsibilities:Submit requests for prior authorizations to insurance companies or third-party payers.Follow up on pending authorizations and ensure timely processing to prevent delays in patient care.Document authorization information in patient records and update as needed.Verify patients' insurance eligibility, benefits, and coverage limitations.Check...

What Youll Do:Manage prior authorization requestsVerify patient eligibility, coverage, and billing detailsReview and process claims accuratelyCoordinate with providers, payers, and patients for missing informationEnsure timely resolution and excellent customer service

Job Summary:Reporting to the Clinical Director and working closely with the Clinical Team, this role plays a key part in ensuring the financial health of the organization. The position serves as a vital link between patients with mental health and/or substance use disorders and insurance providers, healthcare services, and billing operations. It is essential...

Qualifications Required QualificationsActive Philippine RN License (PHRN)Clinical experience (hospital or clinic experience preferred)Good understanding of medical terminologyGood English communication skillsPreferred / AdvantageExperience in US Healthcare BPO/CPOKnowledge of:Utilization Management (UM)Prior Authorization (PA)Medical Coding basics (ICD-10,...

EOR: One Workforce GlobalEmployment Type: Full-Time EmploymentWork Setup: 100% Onsite (Office location in either Eastwood, Clark or Muntinlupa)Work Schedule: Night Shift (Following U.S. Time Zone)Position Overview:The Pharmacy Prior Authorization Specialist is responsible for handling and processing medication prior authorization (PA) requests with minimal...

Job Description:Receive requests for prior authorizations using the Scheduling module of the Electronic Health Record (EHR) and/or via phone or fax and ensure that they are closely monitored.Process referrals and submit medical records to insurance carriers to expedite prior authorization processes.Review the patient's medical history and insurance coverage...

ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Healthcare Case Manager to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture...

This is a remote position. Job Highlights: • Permanent work from home • Schedule: Monday to Friday 8:30 AM - 4:30 PM Florida Time with a 30-minute unpaid break  • Client Timezone: FloridaResponsibilities:• Completes accurate and timely insurance verification. • Completes accurate and timely third party prior payer authorization requests, including...

About the RoleWe are seeking highly skilledMedication Support Representativesto join our remote care coordination team supporting U.S.-based behavioral health providers. This role ensures accurate medication management, timely communication with pharmacies, providers, and patients, and compliance with clinical and documentation standards.Candidates must...