Payer Authorization Operations Associate

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

📋 Description

• Gather, assess, validate, and monitor the documentation necessary for payer authorizations and re-authorizations.

• Prepare and submit comprehensive authorization packets prior to expiration to avert interruptions in patient care.

• Ensure that documentation complies with Medicaid, Medicare, payer, and state-specific requirements.

• Maintain precise documentation and records within internal systems.

• Act as the primary contact for families and caregivers concerning authorization status, documentation needs, and benefit inquiries.

• Handle approximately 50–70 inbound and outbound calls each day.

• Address phone, email, and text inquiries, ensuring prompt follow-up.

• Monitor authorization timelines and proactively identify upcoming expiration dates.

• Prioritize competing demands while upholding high accuracy and service standards.

• Detect documentation issues and collaborate with internal teams to resolve them.

• Work in partnership with Onboarding, Credentialing, Family Support, Clinical Operations, and other internal teams.

• Escalate complex authorization issues as necessary.

• Contribute to process enhancements that improve efficiency and minimize authorization delays.

⛳️ Requirements

• A minimum of 2 years of experience in healthcare operations, healthcare administration, customer service, or administrative support.

• Experience in managing prior authorizations, payer documentation, or healthcare operations.

• Demonstrated success in handling a high volume of inbound and outbound calls in a fast-paced environment.

• Proven experience in managing documentation with exceptional accuracy and attention to detail.

• Familiarity with HIPAA, Medicaid, Medicare, or healthcare documentation standards.

• Proficient in using CRM systems and collaboration tools such as Salesforce, Slack, Google Workspace, or similar platforms.

• Strong organizational and time-management abilities with the capacity to prioritize multiple competing deadlines.

• Excellent written and verbal communication skills in English.

• Employment is contingent upon successful completion of a background check, satisfactory references, and any required documentation.

• Availability to work Monday–Friday, 9:00 AM–5:00 PM Eastern Time.

🏝️ Benefits

• Eligibility for an annual company performance bonus for global team members.

• 15 days of paid time off.

• 10 paid company holidays in the US.

• Opportunities for growth and development of leadership skills.

• Flexible remote work arrangement.