Authorizations Specialists

3 days ago

Ormoc City, Eastern Visayas, Philippines Virtual Staffing Solutions Full time ₱1,200,000 - ₱2,400,000 per year
Description

Virtual Staffing Solutions is seeking Authorization Specialists to join our healthcare support team. In this role, you will be responsible for obtaining, verifying, and processing prior authorizations in compliance with payer and regulatory guidelines. You will ensure accurate documentation and timely approvals, helping providers and patients navigate insurance requirements effectively.

Key Responsibilities
  • Secure and verify prior authorizations for medical services, medications, and procedures.
  • Review medical records, CPT/ICD codes, and insurance policies to ensure compliance with payer guidelines.
  • Communicate with providers, payers, and patients to confirm authorization status and requirements.
  • Maintain accurate and timely documentation within healthcare management systems.
  • Monitor authorization requests to prevent delays or denials of care.
  • Collaborate with clinical and administrative teams to resolve issues and support patient care.
  • Adhere to HIPAA, CMS, and organizational policies while handling sensitive information.
  • Identify opportunities to improve authorization processes and workflows.
Skills, Knowledge & Expertise
  • Familiarity with medical terminology, CPT/ICD codes, and healthcare payer processes.
  • Strong knowledge of insurance and authorization requirements, preferably in a home health or managed care setting.
  • Proficiency in MS Office applications and healthcare management systems.
  • Excellent attention to detail, accuracy, and organizational skills.
  • Impeccable verbal and written communication abilities.
  • Ability to work independently and collaboratively in a fast-paced environment.
  • Strong analytical and problem-solving skills.
  • Customer service orientation with a professional and empathetic approach.
  • Ability to manage multiple priorities with accuracy and efficiency.
  • Knowledge of healthcare compliance and regulatory requirements (HIPAA, CMS, etc.).
  • Proactive mindset with the ability to identify and implement process improvements.
About Virtual Staffing Solutions

We specialize in delivering innovative solutions and exceptional services to meet the diverse needs of our clients. With a strong commitment to quality and customer satisfaction, we strive to exceed expectations and drive success in every project we undertake.

  • Prior Authorization Specialist

    2 days ago

    Cebu City, Central Visayas, Philippines Hirebiz Inc. Full time ₱900,000 - ₱1,200,000 per year

    We're looking for a detail-oriented and experienced Prior Authorization Specialist to join our growing team. In this role, you will be responsible for handling pre-certifications, verifying insurance coverage, and ensuring timely approvals for medical procedures, medications, and services. Your work will directly support patients in accessing the care they...

  • Peer Review Specialist

    3 days ago

    Cebu City, Central Visayas, Philippines RemoteRaven Full time ₱45,000 - ₱55,000 per year

    Hiring: Peer Review Specialist – Behavioral Health | $10–$11/hr | RemoteAre you a licensed RN, NP, MD/DO, or Licensed Therapist with experience in behavioral health and insurance reviews? Join us as a Peer Review Specialist, where you'll ensure clients continue receiving the care they need by securing payer authorizations, reviewing documentation, and...

  • Return Merchandise Authorization Specialist

    3 days ago

    Cebu City, Central Visayas, Philippines XP Plus Solutions Inc. Full time ₱400,000 - ₱600,000 per year

    Duties and Responsibilities:• Receive RMA tickets in the Salesforce system.• Update RMA ticket information and status in Salesforce throughout the replacement process.• Process replacement RMAs with 100% accuracy• Reviews and ensure all information submitted on the form and checks for missing information, duplicate cases, multiple RMAs for the same...

  • Eligibility and Verifications Specialist

    3 weeks ago

    Cebu City, Central Visayas, Philippines Staff4Me Full time

    Summary:An Eligibility and Verifications Specialist's main responsibility is verifying insurance coverage, estimating patient cost-sharing responsibilities, and determining the coverage of specific services, devices, and treatment modalities under patients' insurance plans. Your expertise will ensure accurate billing, streamline administrative processes, and...

  • Publishing Specialist/Consultant

    2 days ago

    Cebu City, Central Visayas, Philippines Open Look Business Solutions Inc Full time ₱250,000 - ₱500,000 per year

    Hiring: Publishing Specialist/Consultant Location: REMOTE-WFH  Cebu City, Cebu, PhilippinesSchedule: Full-time, Amenable to work in US-Time zonesStart Date: ImmediateCompensation: Starting at 40,000 Basic PayWhy Join us? -100% Work-from-Home Setup-Employment Regularization After 6 Months-PH Government Mandated Benefits (SSS, Pag-IBIG, PhilHealth)-13th Month...

  • Sales and Marketing Specialist

    4 weeks ago

    Cebu City, Central Visayas, Philippines Cyberbacker Careers Full time

    OverviewSales and Marketing Specialist (Work from Home) – Join to apply for the Sales and Marketing Specialist (Work from Home) role at Cyberbacker Careers.ResponsibilitiesDominate your market: Identify, target, and win new business opportunities.Crush your quotas: Exceed monthly and quarterly sales goals and push for more.Sell with confidence: Be the...

  • Medical Billing Claims Specialist

    1 week ago

    Iloilo City, Western Visayas, Philippines Caring One Iloilo Inc Full time ₱200,000 - ₱240,000 per year

    Position SummaryThe Billing Claims Specialist is responsible for the accurate and timely processing of medical claims, including charge entry, denial management, and appeals. This role ensures outstanding and past-due claims are resolved, maintains compliance with payer and regulatory requirements, and provides support to patients with billing inquiries. The...

  • Medical Records Specialist

    2 weeks ago

    Cebu City, Central Visayas, Philippines Staff4Me Full time

    The Medical Records Specialist will play a key role in supporting our personal injury cases by managing the request, follow-up, and organization of medical records and billing documentation. This is a critical position that helps ensure timely and complete documentation for new cases.Request medical records and billing statements from hospitals, emergency...

  • Case Specialist 196,197,198

    3 weeks ago

    Mandaue City, Central Visayas, Philippines Groupe ProductLife Full time

    ProductLife Group is looking for a Case Specialist to join our dynamic team to contribute to the activities performed in the Hub:Responsibilities:Data entry of vigilance cases in the relevant databases according to relevant conventionsQuality control of vigilance cases and other documents associated to safety reportsMedical review of vigilance cases...

  • Patient Care Advocate

    3 days ago

    Cebu City, Central Visayas, Philippines DermX Support Inc. Full time ₱800,000 - ₱1,200,000 per year

    Position Overview:Join our dynamic healthcare team as a Patient Care Advocate and become the reassuring voice our patients hear when they need it most. In this vital role, you'll go beyond appointments and phone calls—you'll help patients navigate the complexities of insurance, authorizations, and billing with compassion and efficiency. If you're...