Healthcare Authorization Specialist

This is a fully remote position, open to applicants in Philippines.

📋 Description

• Confirm patient insurance eligibility, benefits, and coverage prior to any treatment or service.

• Obtain prior authorizations from insurance providers for planned medical services and treatments.

• Accurately complete and submit authorization requests within the required turnaround times.

• Communicate with insurance companies via phone and payer portals to secure authorization approvals and verify coverage information.

• Collaborate with internal clinical and administrative teams regarding authorization status and any additional documentation needs.

• Keep precise and current records of insurance verifications, authorizations, approvals, denials, and follow-up actions.

• Monitor pending authorization requests and take proactive steps to avoid delays in patient care.

• Review payer requirements to ensure all submitted documentation complies with insurance guidelines.

• Elevate authorization issues or delays to the relevant internal stakeholders when necessary.

• Ensure adherence to patient confidentiality standards and relevant healthcare regulations.

• Carry out other related duties as assigned.

⛳️ Requirements

• Preferred experience in healthcare prior authorization, insurance verification, medical billing, revenue cycle, or a similar healthcare administrative role.

• Strong knowledge of insurance eligibility verification, prior authorization procedures, and healthcare payer requirements.

• Familiarity with medical terminology.

• Experience using insurance payer websites and online portals.

• Excellent verbal and written communication abilities, with a professional demeanor when engaging with insurance representatives and internal teams.

• High attention to detail and accuracy in managing patient and insurance information.

• Strong analytical and problem-solving capabilities.

• Exceptional organizational and time management skills, with the ability to prioritize tasks in a dynamic environment.

• Ability to work independently while handling multiple authorization requests and adhering to strict turnaround times.

• Proficiency in Microsoft Office applications and familiarity with healthcare information systems or electronic medical records (EMR/EHR) is a plus.

• Capacity to perform effectively in a time-sensitive environment where prompt authorizations directly affect patient access to cancer treatment.

🏝️ Benefits

• Observance of US holidays.