Night-Shift Insurance Verification Analyst (EPIC)

John Clements Consultants, Inc.; Philippines; On-site; PHP 279,000 - 502,000; Full time

Job summary

John Clements Consultants, Inc. seeks an Insurance Verification Specialist to verify coverage, obtain authorizations, and register insurance details in our EHR system.

The role emphasizes accurate documentation, timely pre-certifications, and collaboration with patients, providers, and payers. The ideal candidate has at least 3 years in prior authorization or verification, 2 years with the EPIC system, and strong CPT/ICD-10 knowledge.

Qualifications

• 3 years of experience in prior authorization, pre-certification, or insurance verification in a physician office or hospital
• 2 years of experience using EPIC
• Orthopedic experience strongly preferred
• Knowledge of CPT/ICD-10 and medical terminology

Responsibilities

• Verify insurance coverage, benefits, and eligibility using payer portals or phone
• Register insurance packages accurately in the EHR/authorization system
• Obtain prior authorization or precertification as needed, including orthopedic services
• Review orders and clinical documentation for authorization submissions
• Submit authorization requests and track statuses, denials, and information requests
• Provide cost estimates (copays, coinsurance, deductibles, out-of-pocket) based on benefits
• Escalate complex issues and communicate delays clearly to internal teams
• Support work queues and assist the Contact Center with insurance-related calls

Skills

Communication

Organization

Time-management

Night shift

On-site work

Tools

EPIC

Job description

John Clements Consultants, Inc. seeks an Insurance Verification Specialist to verify coverage, obtain authorizations, and register insurance details in our EHR system.

The role emphasizes accurate documentation, timely pre-certifications, and collaboration with patients, providers, and payers. The ideal candidate has at least 3 years in prior authorization or verification, 2 years with the EPIC system, and strong CPT/ICD-10 knowledge.