Patient Access & Prior Authorization Specialist

Our Clients; Philippines; On-site; PHP 279,000 - 391,000; Full time

Job summary

Our Clients is seeking a Healthcare Customer Service Representative to support patient access and prior authorization processes in a fast-paced environment. The role involves verifying insurance eligibility, explaining financial responsibilities, and guiding patients through required documentation for services.

The ideal candidate will have strong English communication skills, attention to detail, and experience in U.S. healthcare or medical billing.

Qualifications

• 1–2 years in healthcare BPO, medical billing, or patient access preferred.
• Experience with prior authorization, eligibility verification, and financial clearance preferred.
• Strong English communication and customer service skills.
• Ability to navigate payer portals and EMR/EHR systems.

Responsibilities

• Verify patient insurance eligibility and benefits using payer sites.
• Review and determine prior authorization requirements and submit requests.
• Provide pre-service estimates and explain patient financial responsibility.
• Handle inbound/outbound calls and support patients, providers, and payers.
• Document interactions and maintain HIPAA-compliant records.

Skills

Excellent communication

Customer service

Attention to detail

English proficiency

HIPAA compliance

US healthcare knowledge

Tools

Epic

Cerner

Athena

Job description

Our Clients is seeking a Healthcare Customer Service Representative to support patient access and prior authorization processes in a fast-paced environment. The role involves verifying insurance eligibility, explaining financial responsibilities, and guiding patients through required documentation for services.

The ideal candidate will have strong English communication skills, attention to detail, and experience in U.S. healthcare or medical billing.