Authorizations Specialists

3 days ago

Ormoc City, Eastern Visayas, Philippines Virtual Staffing Solutions Full time $40,000 - $60,000 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.

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