On-Site Authorization & Referral Specialist

The Philippine Operations Center Global Solutions Inc.; Central Visayas; On-site; PHP 260,000 - 480,000; Full time

Job summary

The Philippine Operations Center Global Solutions Inc. in the Philippines is seeking an Authorization & Referral Coordinator (on-site) to ensure timely and compliant processing of referrals, authorizations, and insurance verifications for patients.

You will review schedules, secure authorizations, verify eligibility, document in the EHR/EMR, and coordinate with clinics and providers. Strong attention to detail and experience in healthcare administration are essential; willingness to work night

Qualifications

• High school diploma or GED required.
• 1 year of experience in referral coordination, insurance verification, or healthcare administration preferred.
• Experience in ophthalmology or surgical scheduling is an advantage.
• Working knowledge of ICD-10 and CPT coding; pre-authorization protocols preferred.

Responsibilities

• Review daily clinic and surgical schedules to identify referral and pre-authorization requirements.
• Prioritize referrals based on clinical urgency and provider availability.
• Secure insurance authorizations for specialist consultations, diagnostics, procedures, and ASC services.
• Coordinate and process pre-surgical authorizations in accordance with payer guidelines.
• Verify patient insurance eligibility and benefits before scheduled appointments.
• Document insurance information in the EHR/EMR system.
• Resolve discrepancies by coordinating with patients, insurers, and internal teams.
• Collaborate with clinics, providers, and call centers regarding status.
• Track co-payments, benefits, and coverage limits.
• Maintain logs of authorizations and communications.
• Manage digital records through scanning, uploading, and faxing documents to the EHR.

Skills

Attention to detail

Organizational skills

Communication skills

Insurance verification

Authorization

Medical billing

Google Workspace

ICD-10 CPT

Night shifts

On-site

Education

High school diploma or GED

Tools

Google Workspace

EHR/EMR System

Job description

The Philippine Operations Center Global Solutions Inc. in the Philippines is seeking an Authorization & Referral Coordinator (on-site) to ensure timely and compliant processing of referrals, authorizations, and insurance verifications for patients.

You will review schedules, secure authorizations, verify eligibility, document in the EHR/EMR, and coordinate with clinics and providers. Strong attention to detail and experience in healthcare administration are essential; willingness to work night