Insurance Verification and Authorization (IV/Auth) Specialist

MicroSourcing; Taguig; Sur place; PHP 446 400 - 613 800; Plein temps

Avantages offerts par ce poste

Healthcare from day one

PTO with cash-out

Group life insurance

Performance bonuses

Flexible work arrangements

Career advancement

Diversity & inclusion

Résumé du poste

MicroSourcing in Taguig, Philippines, is seeking an Insurance Verification and Authorization (IV/Auth) Specialist for full-time, on-site night shift supporting US time zones. You will verify eligibility, process authorizations, and coordinate with US providers and patients to ensure timely, HIPAA-compliant workflows.

The role requires EMR experience (Epic/Cerner/Meditech), strong English communication, and proficiency with MS Office. Night shifts and US-time alignment are essential.

Qualifications

• At least 1 year of U.S. healthcare insurance verification and authorization experience.
• Senior High School Diploma or equivalent.
• Experience with an electronic medical record (EMR) system (Epic, Cerner, Meditech).
• Strong understanding of insurance verification processes and benefit determination.
• Familiarity with payer portals and insurance websites for checking authorization and eligibility status.
• Proficiency in MS Office Standard Tools (Word, Outlook, Excel, etc.).
• Excellent verbal and written English communication skills (CEFR level B2 or higher).
• Willingness to work night shifts and adapt to U.S. time zones.

Responsabilités

• Insurance Verification: Verify insurance and benefit eligibility for patient services.
• Authorization: Review clinical documentation and insurance guidelines to determine authorization requirements; verify accuracy of authorizations; obtain authorizations for scheduled services; ensure timely submission and follow-up.
• Payer and Patient Outreach and Communication: Perform outbound calls and online inquiries to verify eligibility and follow up on prior authorization requests; handle inbound calls from U.S.-based patients and providers; coordinate with physician offices to obtain missing documentation.
• Documentation: Accurately enter and update authorization, eligibility, benefit, and patient demographics in client systems; document all payer communication and account activity.
• Maintain confidentiality and HIPAA compliance; adhere to IV/Auth quality and productivity standards.

Connaissances

US healthcare insurance verification

EMR (Epic/Cerner/Meditech)

MS Office (Word/Excel/Outlook)

English communication (B2+)

Night shift readiness

Formation

Senior High School Diploma

Outils

Epic

Cerner

Meditech

Description du poste

Position

Insurance Verification and Authorization (IV/Auth) Specialist

Location

Taguig, Metro Manila, Philippines

Employment Type

Full‑Time, On‑Site, Night Shift (US time zones)

Salary

PHP 40,000 – 55,000 per month

Job Overview

The Insurance Verification and Authorization (IV/Auth) Specialist verifies eligibility and initiates and/or follows up on prior authorization requests with insurance companies, providers, and patients in the US. The role ensures timely and accurate processing of authorization requests, coordinates with clinical teams, and maintains compliance with payer guidelines and HIPAA standards.

Responsibilities

• Insurance Verification
  • Verify insurance and benefit eligibility for patient services
• Authorization
  • Review clinical documentation and insurance guidelines to determine authorization requirements
  • Verify the accuracy of authorizations obtained by provider offices (CPT code, patient demographics, effective dates)
  • Obtain authorizations for scheduled services from insurance or third parties as necessary
  • Ensure timely submission and follow‑up of prior authorization requests to meet turnaround time expectations
  • Identify and alleviate authorization denials or delays by escalating to the appropriate team
  • Notify admission as required by payers
  • Review medical necessity criteria and payer‑specific guidelines
• Payer and Patient Outreach and Communication
  • Perform outbound calls and online inquiries to verify eligibility and follow up on prior authorization requests
  • Handle inbound calls from U.S.‑based patients and providers with empathy and professionalism
  • Coordinate with physician offices and clinical teams to obtain missing documentation
• Documentation
  • Accurately enter and update authorization, eligibility, benefit, and patient demographic details in the client system (e.g., Epic, Meditech, Cerner)
  • Document all payer communication and account activity according to defined standards
• Maintain high confidentiality, professionalism, and compliance with HIPAA and other regulatory standards to protect patient information
• Adhere to the IV/Auth quality and productivity standards established by the organization

Qualifications

• At least one year of U.S. healthcare industry experience completing insurance verification and authorization activities
• Senior High School Diploma or equivalent
• Experience with an electronic medical record (EMR) system (e.g., Epic, Cerner, Meditech)
• Strong understanding of insurance verification processes and benefit determination
• Familiarity with payer portals and insurance websites for checking authorization and eligibility status
• Proficiency in MS Office Standard Tools (Word, Outlook, Excel, etc.)
• Excellent verbal and written English communication skills (CEFR level B2 or higher) and customer service skills
• Willingness to work on night shifts and adapt to U.S. time zones

Preferred Skills

• Two or more years of U.S. healthcare industry experience completing insurance verification and authorization activities
• Philippine bachelor’s degree or equivalent preferred
• Knowledge of CPT and ICD‑10 coding

Soft Skills

• Ability to prioritize amid competing priorities
• Strong analytical, critical thinking, and problem‑solving skills
• Proven adaptability to new and changing technical environments
• Attention to detail; strong follow‑up and follow‑through skills
• Ability to make complex decisions independently within the scope of the position
• Independent judgment, discretion, and decision‑making capabilities
• Teamwork and integrity in all work‑related activities
• Professional interaction with internal and external customers

Benefits

• Competitive compensation above market rates
• Healthcare coverage on day one, including dependents
• Paid time‑off with cash conversion
• Group life insurance
• Performance bonuses
• Collaborative work environment with company‑sponsored events
• Flexible work arrangements for work‑life harmony
• Opportunities for continuous learning and career advancement
• Inclusive culture celebrating diversity