Onsite Night-Shift Orthopedic Authorization Specialist

John Clements Consultants, Inc.; Philippines; On-site; PHP 446,000 - 781,000; Full time

Job summary

John Clements Consultants, Inc. in the Philippines seeks an Authorization Specialist to obtain prior authorizations for orthopedic services, PM&R, and related procedures, ensuring timely patient access and compliance with payer requirements.

You will review orders and documentation, coordinate with physicians and payers, and document details in the EHR, managing denials and inquiries during onsite night shifts at Bridgetown, Quezon City.

Qualifications

• Bachelor's degree required.
• 2+ years of experience in prior authorization, pre-certification, or insurance verification in a physician office, hospital, or healthcare BPO/Shared Services.
• Strong knowledge of insurance authorization processes and payer requirements.
• Familiarity with CPT, ICD-10, and basic medical terminology.
• Ability to interpret clinical documentation and payer medical necessity guidelines.
• Familiar with EHR systems, pre-certification platforms, and payer portals.
• Willing to work onsite (Bridgetown, Quezon City) and night shift schedule.

Responsibilities

• Obtain prior authorizations and precertification for orthopedic services, including surgical procedures, PM&R services, or ancillary services.
• Review provider orders, clinical documentation, and diagnoses for completeness and accuracy.
• Collaborate with physicians, clinical staff, scheduling, and other partnering teams to obtain required documentation.
• Submit authorization requests via authorization vendor portals, payer portals, phone, fax, etc.

Skills

Attention to detail

Communication with payers

Analytical skills

Night shift adaptability

Education

Bachelor's degree

Tools

EHR systems

Payer portals

Job description

John Clements Consultants, Inc. in the Philippines seeks an Authorization Specialist to obtain prior authorizations for orthopedic services, PM&R, and related procedures, ensuring timely patient access and compliance with payer requirements.

You will review orders and documentation, coordinate with physicians and payers, and document details in the EHR, managing denials and inquiries during onsite night shifts at Bridgetown, Quezon City.