Prior Authorization Specialist

We are seeking a detail-oriented and experienced Prior Authorization Specialist to manage the full lifecycle of prior authorizations (PAs) for medical services. The ideal candidate will be responsible for timely submission, meticulous follow-up, and effective resolution of all prior authorization requests and subsequent appeals. This role is critical in...

EOR: One Workforce GlobalEmployment Type: Full-Time EmploymentWork Setup: 100% Onsite (Office location in either Eastwood, Clark or Muntinlupa)Work Schedule: Night Shift (Following U.S. Time Zone)Position Overview:The Pharmacy Prior Authorization Specialist is responsible for handling and processing medication prior authorization (PA) requests with minimal...

Responsibilities:Submit requests for prior authorizations to insurance companies or third-party payers.Follow up on pending authorizations and ensure timely processing to prevent delays in patient care.Document authorization information in patient records and update as needed.Verify patients' insurance eligibility, benefits, and coverage limitations.Check...

Job Summary:Reporting to the Clinical Director and working closely with the Clinical Team, this role plays a key part in ensuring the financial health of the organization. The position serves as a vital link between patients with mental health and/or substance use disorders and insurance providers, healthcare services, and billing operations. It is essential...

Job Description:Receive requests for prior authorizations using the Scheduling module of the Electronic Health Record (EHR) and/or via phone or fax and ensure that they are closely monitored.Process referrals and submit medical records to insurance carriers to expedite prior authorization processes.Review the patient's medical history and insurance coverage...

What Youll Do:Manage prior authorization requestsVerify patient eligibility, coverage, and billing detailsReview and process claims accuratelyCoordinate with providers, payers, and patients for missing informationEnsure timely resolution and excellent customer service

ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Healthcare Case Manager to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture...

We are actively hiring a Philippine Registered Nurse (PHRN) with experience in BPO Prior Authorization and Appeals. Join our growing team in Bridgetowne, QC and be part of a company that offers competitive compensation, career growth, and a supportive work environment.Qualifications:Must be a PHRN (Active PRC license)At least 1 year BPO experience handling...

This is a remote position. Job Highlights: • Permanent work from home • Schedule: Monday to Friday 8:30 AM - 4:30 PM Florida Time with a 30-minute unpaid break  • Client Timezone: FloridaResponsibilities:• Completes accurate and timely insurance verification. • Completes accurate and timely third party prior payer authorization requests, including...

DescriptionISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Healthcare Customer Service Representative to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride...