Healthcare Pre-Auth & Scheduling Lead

Our Clients; Philippines; On-site; PHP 600,000 - 900,000; Full time

Job summary

Our Clients in the Philippines seeks a Healthcare Lead to oversee day-to-day operations of pre-certification, prior authorization, scheduling, and patient access to ensure timely, accurate, and compliant processing of healthcare services.

The role provides leadership to the team, monitors performance, handles escalations, and collaborates with clinical teams, providers, payers, and scheduling to maintain efficient workflows.

Qualifications

• Bachelor’s degree in a healthcare-related field.
• Minimum 3–5 years of healthcare experience in pre-certification and prior authorization.
• At least 2 years in leadership, supervision, or workflow coordination.
• Knowledge of insurance requirements and healthcare workflows.
• Familiar with CPT, ICD-10, EHR systems, and payer portals.

Responsibilities

• Oversee daily pre-certification, prior authorization, and scheduling workflows.
• Monitor team productivity, quality, turnaround times, accuracy, and service levels.
• Provide coaching, guidance, and performance support to team members.
• Handle escalated authorization, payer, scheduling, and patient access issues.
• Ensure documentation of authorization and scheduling in EHR and related systems.
• Coordinate with clinical teams, providers, payers, and front-end staff to prevent delays.
• Ensure compliance with payer requirements, medical necessity guidelines, and policies.
• Maintain and improve SOPs, workflows, and operational guidelines.
• Identify process gaps and implement improvements to reduce delays and denials.
• Support staffing, workload allocation, training, and team performance activities.
• Prepare operational reports and communicate performance updates to leadership.

Skills

Healthcare management

Leadership

Communication

Analytical

Problem-solving

Organizational

Education

Bachelor’s degree in Healthcare Management, Business Administration, Nursing, or related field

Tools

EHR systems

Payer portals

Authorization platforms

Job description

Our Clients in the Philippines seeks a Healthcare Lead to oversee day-to-day operations of pre-certification, prior authorization, scheduling, and patient access to ensure timely, accurate, and compliant processing of healthcare services.

The role provides leadership to the team, monitors performance, handles escalations, and collaborates with clinical teams, providers, payers, and scheduling to maintain efficient workflows.