Prior Authorization Specialist

1 day ago

Pasig, National Capital Region, Philippines Connext Full time ₱900,000 - ₱1,200,000 per year

Connext Global Solutions
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 an
Prior Authorization Specialist
who will be working with Connext's Client in the United States of America.

What's in it for you?

  • Competitive compensation
  • Perfect Attendance Bonus
  • Life insurance
  • HMO Insurance
  • Great company culture
  • Annual Merit Increase
  • 25% Night Differential
  • Php 5,000 Sign-On Bonus

What is the job?

The
Prior Authorization Specialist
is responsible for conducting insurance verifications and obtaining prior authorizations for a diverse range of services of the client.

  • Verify patient eligibility and benefits via portal and/or phone call, including collecting referral and authorization requirements, across multiple payers, states, insurance products, and specialties within customer SLAs.
  • Work closely with providers to collect accurate patient and medical records and communicate authorization decisions.

Required Qualifications:

  • Minimum of one (1) year experience with medical billing and/or understanding of benefits including deductibles, co-insurance, out of pocket and benefits exclusions.
  • Familiar with providers software, including Electronic Medical Record Systems (EMR/EHR) and Practice Management Systems (PMS).
  • Experience with HMOs, PPOs, POSs, EPOs, Medicare, Medicaid. Understanding of each through the referral and authorization process.

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