Patient Access & Prior Authorization Specialist

PM Consulting; Philippines; On-site; PHP 240,000 - 360,000; Full time

Job summary

PM Consulting seeks a Healthcare Customer Service Representative to support patients, providers, and insurers with insurance eligibility, benefits verification, prior authorization, and pre-service estimates. The role emphasizes accurate information, strong communication, and privacy adherence in a fast-paced environment.

The ideal candidate has 1–2 years of healthcare BPO experience or related environment, strong English skills, and the ability to navigate payer portals and EMR/EHR systems such

Qualifications

• Strong verbal and written English communication skills.
• Excellent customer service and interpersonal skills.
• Strong attention to detail and ability to handle sensitive information accurately.
• Ability to navigate multiple systems, payer portals, and healthcare applications.

Responsibilities

• Verify patient insurance eligibility and coverage using payer websites, portals, and internal systems.
• Review benefits, deductibles, copayments, coinsurance, and out-of-pocket responsibilities.
• Identify and communicate authorization, referral, or coverage requirements.
• Initiate and submit prior authorization requests to insurance payers.
• Calculate or communicate estimated patient financial responsibility.
• Handle inbound/outbound calls with patients, providers, and insurers.
• Document interactions and verification results in appropriate systems.
• Follow HIPAA, payer requirements, and client policies.

Skills

English communication

Customer service

Attention to detail

Multi-system navigation

Tools

Epic

Cerner

Athena

Job description

PM Consulting seeks a Healthcare Customer Service Representative to support patients, providers, and insurers with insurance eligibility, benefits verification, prior authorization, and pre-service estimates. The role emphasizes accurate information, strong communication, and privacy adherence in a fast-paced environment.

The ideal candidate has 1–2 years of healthcare BPO experience or related environment, strong English skills, and the ability to navigate payer portals and EMR/EHR systems such