Lead Prior Authorization & Eligibility Specialist (Night Shift)

Our Clients; Philippines; On-site; PHP 360,000 - 720,000; Full time

Job summary

Our Clients in Bridgetowne, Quezon City, onsite overnight shift seeks an experienced Account Specialist for the Patient Access – Benefits & Authorization team. You will supervise daily insurance verification, benefits review and authorization workflows, coaching a team while ensuring accuracy and payer alignment.

Applicants should have 3–5 years in patient access or revenue cycle, strong knowledge of CPT/ ICD-10 and EHR systems, and excellent leadership and communication skills.

Qualifications

• High School Diploma or equivalent; Associate's or Bachelor's degree preferred.
• 3–5 years of experience in Patient Access, Insurance Verification, Benefits, referrals, authorizations or Revenue Cycle.
• Solid knowledge of verification, benefits interpretation, authorizations, payer requirements and patient financial responsibility.
• Familiarity with CPT, ICD-10, medical terminology, payer guidelines.
• Proficiency in EHR systems, eligibility tools, pre-certification platforms and reporting tools.

Responsibilities

• Supervise daily operations involving verification, benefits review, registration, referrals, authorization support and patient financial workflows.
• Monitor team productivity, quality, and service levels and provide coaching and feedback.
• Act as SME on payer requirements, eligibility, referrals, authorizations and network status.
• Review team documentation for accuracy and compliance.
• Handle escalated inquiries from patients, providers, payers and internal teams.
• Collaborate with Front Office, Clinical, Revenue Cycle and leadership to improve workflows.
• Support staffing, workload balancing, process improvement and QA initiatives.
• Prepare operational and performance reports for leadership.
• Ensure compliance with policies, payer requirements, privacy and regulations.

Skills

Leadership

Communication

Organizational

Analytical

Problem-solving

Coaching

Conflict resolution

Workflow improvement

Time management

Education

Healthcare Administration

Bachelor's preferred

Tools

Payer portals

Microsoft Office

Reporting tools

Job description

Our Clients in Bridgetowne, Quezon City, onsite overnight shift seeks an experienced Account Specialist for the Patient Access – Benefits & Authorization team. You will supervise daily insurance verification, benefits review and authorization workflows, coaching a team while ensuring accuracy and payer alignment.

Applicants should have 3–5 years in patient access or revenue cycle, strong knowledge of CPT/ ICD-10 and EHR systems, and excellent leadership and communication skills.