
Team Lead Pharmacy Authorization
4 days ago
Job Title: Team Leader Pharmacy Authorization (RN)
Location: McKinley, Taguig City
Work Set-up: Onsite
OUR COMPANY
AGS Health is more than a revenue cycle management company–we're a strategic partner for growth. With expert services complemented by AI-enabled technologies and high-touch support, AGS Health is the premier revenue cycle partner for leading health systems, physician groups, and academic medical centers in the U.S. With expert insight into modern revenue cycle practices, the company pairs cutting-edge technology with college-educated, trained RCM experts to help clients optimize workflows, maintain compliance, prevent revenue leakage, and achieve a high-performance revenue cycle. AGS Health employs more than 12,000 team members globally and partners with more than 100 clients across a variety of care settings, specialties, and billing systems.
For more details, please visit
RESPONSIBILITIES
Team Management
- Provide the team with the company's vision and the objectives of all processes.
- Have excellent people management skills to ensure adequate production and quality SLAs (service level agreements) are met
- Provide adequate training and knowledge sharing to the team by conducting daily and weekly meetings which are documented and acknowledged by the team
- Monitoring daily production output and validating the same by means of timesheet approvals
- Monitoring daily quality reviews of the quality audit team to ensure feedback is provided to the team and identified areas of concern are reviewed and completed in a timely manner
- Monitoring and adhering to the company policies regarding leave and absenteeism within the team
- Provide monthly performance report to the team on production & quality achievements and their areas for improvement
- Serve as a SPOC (single point of contact) to communicate and resolve interface and integration issues with other teams
- Adequate staffing is allocated within the various processes that need to be reported back to the client
- Control Talent Retention to the minimum – attrition
Process Handling
- Contact insurance carriers to verify patient's insurance eligibility, benefits and requirements.
- Request, track and obtain pre-authorization from insurance carriers within time allotted for medical and services.
- Review, request, follow up and secure authorizations for high dollar cost oncology chemotherapy drugs.
- Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations.
- Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed.
- Review denials and follow up with provider to obtain medically necessary information to submit an appeal of the denial.
- Prioritize the incoming authorizations by level of urgency to the patient.
- Manage correspondence with insurance companies, physicians, specialists, and patients as needed, including documenting in the EHR as appropriate.
- Respond to clinical questions regarding payer medical policy guidelines.
COMPETENCIES, SKILLS AND OTHER REQUISITES
- Excellent written and spoken English
- Unflinching integrity and personal work ethics
- Self-starter who strives for self and team excellence
- Flair for client satisfaction
- Attention to detail and concern for accuracy
- Excellent time management skills and multi-tasking ability
- Excellent team player
- Compliant to rules and regulations
ACADEMIC AND PROFESSIONAL BACKGROUND
- Academic qualification for this role is a graduate in Nursing.
- Required Certifications/Licensure: Registered Nurse currently licensed.
-
Taguig, National Capital Region, Philippines Nezda Technologies, Inc. Full time ₱53,000 per yearWe Are Hiring: Clinical Authorization Specialists (Surgery, Pharmacy, Oncology) - BLENDED ACCOUNT Taguig | Night Shift | Onsite | Up to 53K Package | Start ASAP - September 22Open Roles:Clinical Authorization SpecialistClinical Authorization Specialist (Pharmacy)Clinical Authorization (Surgery & Oncology)QA – Clinical Authorization (Surgery &...
-
Pharmacy Technician Recruiter
4 days ago
Taguig, National Capital Region, Philippines Philtech Inc. Full time $40,000 - $60,000 per yearWhat you will be doing:You will play a key role in building the future of our company by collaborating with hiring managers and HR to perform efficient full-cycle recruiting. You will represent Albertsons Companies and will serve as the face of the company, being the first point of contact most jobseekers will have with us.This role brings top talent into...
-
HIRING: PHRN- Prior Authorizations
4 days ago
Taguig, National Capital Region, Philippines Nezda Technologies, Inc. Full time ₱900,000 - ₱1,200,000 per yearAbout the role Nezda Technologies, Inc.' is seeking a dedicated and experienced PHRN - Prior Authorizations to join our dynamic team in Taguig City Metro Manila. In this full-time position, you will play a crucial role in managing the prior authorization process, ensuring timely and efficient approvals for our healthcare clients.What you'll be...
-
Taguig, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time ₱900,000 - ₱1,200,000 per yearAbout the role Seeking licensed Pharmacists to join our esteemed healthcare BPO team in Taguig City, Metro Manila. As a Licensed Pharmacist, you will play a crucial role in providing expert pharmaceutical services and guidance to our clients and their patients. This full-time position offers a unique opportunity to leverage your healthcare expertise within...
-
Medical Allied
4 weeks ago
Taguig, National Capital Region, Philippines Santaisabel Full timeMinimum RequirementsCandidate must possess at least a Bachelor's/College Degree in Medical Science.Fresh Graduates / Entry Level specializing in Healthcare - Nurse/Medical Support and Assistant or equivalent.ResponsibilitiesThis role is expected to coordinate the execution and continued quality of the client's department processes, perform assigned duties...
-
General Accounting Team Lead
2 days ago
Taguig, National Capital Region, Philippines CITADEL Full time ₱2,000,000 - ₱2,500,000 per yearDuties and Responsibilities:Provide timely, accurate and compliant record to report services including statutory reporting in accordance with local IFRS principles.Ensure accurate and timely posting of financial transactions.Establish and manage metrics to measure service performance, quality, and customer satisfaction for end-to-end Record-to-Report process...
-
Team Lead
4 days ago
Taguig, National Capital Region, Philippines Nezda Technologies, Inc. Full time ₱1,200,000 - ₱2,400,000 per yearWE ARE HIRING: Team Lead – ED / Surgery Coding / Outpatient Coding Location: Taguig | Dayshift | OnsiteAbout the Role:We are looking for an experienced Team Lead – ED / Surgery Coding (Facility Coding) who will oversee coding and auditing operations while ensuring high-quality service delivery and team performance.Key Qualifications:Proven expertise in...
-
Team Lead
2 days ago
Taguig, National Capital Region, Philippines SpringSkill Full time ₱900,000 - ₱1,200,000 per yearJob Title: Team Lead – ED / Surgery CodingLocation: Taguig.Salary: NegotiableAbout the RoleWe are seeking an experienced Team Lead – ED / Surgery Coding to oversee the daily operations of a coding and auditing team. The ideal candidate will have proven expertise in Emergency Department (ED) Facility, Surgery, and Observation Coding, combined with strong...
-
Prior Authorization Specialist
4 days ago
Taguig, National Capital Region, Philippines Systemantech Full time ₱336,000 per yearJOB RESPONSIBILITIES:Contact insurance companies to verify coverage status of patient benefits.Files pre-authorizations for patients with insurance companies and provide follow up as needed.Process supply orders.Maintains accurate patient information in relevant Acelis Connected Health data management systems.Provides patients with information regarding...
-
Team Lead
4 days ago
Taguig, National Capital Region, Philippines HelloConnect Full time ₱1,500,000 - ₱2,500,000 per yearAs aTeam Leader, you will oversee the daily operations and performance of your team, ensuring Service Level. Agreements (SLAs) and Key Performance Indicators (KPIs) are consistently met. Youll manage team schedules, conduct coaching sessions, and lead development initiatives, such as team huddles, to enhance individual and team performance. Your role...