Prior Authorization Coordinator
1 week ago
About Clinovation Corp
Clinovation Corp is a dedicated healthcare back-office provider supporting U.S. medical practices through accurate, compliant, and efficient administrative operations. Our team handles critical functions such as insurance verifications, prior authorizations, eligibility checks, billing, collections, and patient coordination. We value precision, accountability, and a service-first mindset to ensure seamless patient access to care.
Key Responsibilities
Authorization Coordination
- Initiate and manage prior authorization requests for procedures, diagnostics, medications, and specialty services.
- Verify patient insurance benefits and eligibility before submission.
- Monitor pending cases, follow up on delays, and handle denials or appeals as needed.
- Maintain complete and accurate documentation of all authorization activities.
Communication & Collaboration
- Coordinate with providers and internal teams to secure required clinical documentation.
- Provide clear updates to patients and team members regarding authorization status and next steps.
- Serve as a liaison with insurance payers to resolve complex or escalated authorization concerns.
Compliance & Documentation
- Ensure adherence to payer-specific policies, medical guidelines, and HIPAA regulations.
- Maintain accurate records within internal systems and EHR platforms.
- Suggest improvements to streamline authorization workflows and reduce turnaround time.
Qualifications
Education & Experience
- High school diploma or equivalent required; healthcare-related degree preferred.
- 1–2 years of experience in prior authorizations, insurance coordination, or medical billing.
- Experience with multispecialty authorizations (imaging, surgeries, DME, meds) is a strong advantage.
Skills & Competencies
- Strong knowledge of insurance requirements, authorization workflows, and medical terminology.
- Excellent attention to detail and the ability to manage multiple cases simultaneously.
- Strong communication skills for interacting with payers, providers, and patients.
- Proficiency with EHR systems, insurance portals, and general office software.
- Problem-solving mindset and ability to work independently.
Benefits
Competitive compensation.
- HMO or healthcare coverage depending on employment status.
- Paid time off and holidays.
- SSS, PAGIBIG, PhilHealth 100% Covered - Zero salary deduction
- Equal Opportunity Statement
Clinovation Corp is an equal opportunity employer. We value diversity and are committed to fostering an inclusive and respectful workplace for all employees.
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