Prior Authorization Specialist

6 days ago

Philippines Staffing for Doctors Full time ₱25,000 - ₱70,000 per year

Staffing for Doctors is seeking a highly skilled Prior Authorization Specialist with experience using Modernizing Medicine (ModMed) software. In this role, you will be responsible for obtaining prior authorizations for various medical services, ensuring timely and accurate submissions to insurance carriers. Your experience with ModMed will be crucial in efficiently processing authorizations and managing communication with both medical providers and patients.

Key Responsibilities
  • Process prior authorization requests using ModMed for a variety of medical services and procedures.
  • Verify patient eligibility and benefits through insurance portals and provide necessary documentation to support authorization requests.
  • Collaborate with healthcare providers to gather required clinical information and ensure all submissions are compliant.
  • Maintain accurate records of all authorizations, including approvals, denials, and follow-ups.
  • Communicate effectively with patients regarding their authorization status and insurance-related inquiries.
  • Keep track of pending requests and manage timelines to ensure timely responses from insurers.
Requirements
  • Minimum of 1-2 years of experience as a Prior Authorization Specialist is required.
  • Must have hands-on experience with ModMed software.
  • Strong understanding of insurance verification and medical billing processes.
  • Excellent verbal and written communication skills for effective patient and provider interactions.
  • Highly organized, detail-oriented, and able to manage multiple requests concurrently.
  • Ability to work independently and as part of a team in a fast-paced environment.

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