prior authorization

Our US partner is one of the leading Medical Digital Imaging Service Providers in New Jersey. They offer a full spectrum of diagnostic imaging services in comfortable, convenient, and friendly outpatient imaging centers. As a Prior Authorization Specialist, you are responsible for obtaining pre-certifications and pre-authorizations for procedures and...

PATIENT ACCESS - LEAD / SUPERVISOR Company: Confidential HiringLocation: Bridgetowne, Quezon CityWork Setup: OnsiteSchedule: Mid Shift We are looking for an experienced Patient Account Specialist Supervisor to oversee the daily operations, performance, quality, and development of the Account Specialist team under Patient Access - Benefits &...

Connext Global Solutions is a dedicated team of business process outsourcing experts and innovators, with experience in supporting world-class companies in Title and Escrow, Healthcare, Produce Distribution, Retail and Fashion, Design Consulting, and Finance. We are currently looking for an Prior Authorization Specialist who will be working with Connext's...

Healthcare Prior Authorization Coordinator Non-Clinical Work Set-up: Onsite - Potential to WFH after training Location: Valero, Makati City Schedule: Graveyard | Shifting Hours Position Summary The Healthcare Prior Authorization Coordinator is responsible for providing administrative support to the Utilization Management (UM) department by coordinating prior...

Neolytix is seeking a Healthcare Associate who already knows the prior authorization world and can step in immediately in a remote, full-time role with a fixed 9PM-6AM PHT schedule. You will own the authorization lifecycle: submit requests through payer portals, collect and validate clinical data, manage follow-ups and deadlines, and support peer-to-peer...

Tata Consultancy Services in the Philippines invites applications for a Prior Authorization Admin Support RN to coordinate and submit prior authorization requests end-to-end. You will gather patient information, verify coverage, and ensure documentation is correctly uploaded to payer portals. Responsibilities include verifying eligibility, entering data into...

Winning Assistants LLC. is seeking a Medical Authorization Specialist (Spine Surgery) to support a U.S.-based spine care practice from a remote location. The role involves processing surgical authorizations, insurance appeals, and portal navigation to ensure timely, accurate approvals. Ideal candidates will have hands-on experience with prior authorizations,...

A7 Recruitment is seeking a Prior Authorization Guideline Specialist to support the Medicaid department by developing and maintaining PA Guidelines, MRFs, and electronic PA rules. The role collaborates with Clinical Account Executives, PA Guidelines staff, and internal teams to ensure accurate documentation and timely distribution. The candidate will assist...

About the job Prior Authorization Nurse - PHRN (QA) Position: Clinical/Prior Authorization - Quality Auditor Qualifications: Must hold an active PHRN license (not a USRN license holder) Must have at least solid 4 to 7 years experience in Clinical/Prior Authorization or Utilization Review Relevant experience as a Quality Auditor in Clinical Services...

Back-Office Insurance & Prior Authorization Remote | Behavioral Health | 30 hours/week | $6/hour Working Hours: 11:00 AM to 7:00 PM US Central Time Role Overview We are seeking an experienced Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a nonprofit behavioral health organization in the United States. This position will...

Tata Consultancy Services in Taguig, Philippines seeks licensed nurses for behavioral health prioritization roles, focusing on psychiatric medication prior authorizations and care coordination. The role emphasizes accurate documentation, patient interactions, and timely processing in a fast-paced setting.The candidate will gather and verify clinical data,...

Job SummaryThe Prior Authorization Specialist & Surgical Scheduler is responsible for securing insurance authorizations and coordinating surgical and procedural scheduling for patients. This role serves as a critical liaison between providers, patients, insurance companies, ambulatory surgery centers (ASC), hospitals, and other healthcare partners to ensure...

A healthcare service provider is looking for an administrative and clinical support professional in Quezon City. The role involves managing electronic medical records, processing medication authorizations, and scheduling patient appointments. Ideal candidates should be graduates of related healthcare courses and possess strong communication and...

DME Service Solutions seeks a Pharmacist for Utilization Management to review prior authorization requests and appeals, applying CMS and FDA criteria to determine medication coverage. You will collaborate with physicians and care teams, document decisions in UR systems, and support appeals with clinical input for US insurance plans. Required are a pharmacy...

Job Description: Core Responsibilities: Manage end-to-end prior authorizations, insurance verifications, and pre-op documentation for 4 assigned providers Submit prior authorization requests for MAC and light anesthesia procedures accurately and promptly Verify patient eligibility, coverage, and COB across commercial payers, Medicare, Medicaid, HMOs, PPOs,...

Core Responsibilities:Manage end-to-end prior authorizations, insurance verifications, and pre-op documentation for 4 assigned providersSubmit prior authorization requests for MAC and light anesthesia procedures accurately and promptlyVerify patient eligibility, coverage, and COB across commercial payers, Medicare, Medicaid, HMOs, PPOs, Workers' Comp, and...

About the role The Prior Authorization Specialist & Surgical Scheduler is responsible for securing insurance authorizations and coordinating surgical and procedural scheduling for patients. This role serves as a critical liaison between providers, patients, insurance companies, ambulatory surgery centers (ASC), hospitals, and other healthcare partners to...

Ubiquity seeks an experienced Team Leader to manage our Prior Authorization operations in Laguna. You will coach agents, ensure payer guideline adherence, and drive performance improvements while coordinating with operations leadership. Responsibilities include training, performance reviews, reporting, and acting as a subject matter expert on prior...

Hammerjack Pty Ltd in Ortigas is seeking a Precertification Coordinator to secure prior authorizations and referrals for cardiac procedures. The role requires processing multispecialty authorizations with payer contact and clinical documentation review.The ideal candidate will have a valid PHRN license, 1 year in BPO/healthcare, and Oncology Data Specialist...

Remote | Behavioral Health | 30 hours/week | $6/hour Working Hours: 11:00 AM to 7:00 PM US Central Time Role Overview We are seeking an experienced Back-Office Insurance & Prior Authorization Virtual Medical Assistant to support a nonprofit behavioral health organization in the United States. This position will focus primarily on the administrative and...