Prior Authorization Consultant | Work From Home

Vector Outsourcing Solutions Philippines; Mandaluyong; On-site; PHP 334,800 - 390,600; Full time

Benefits offered by this job

Equipment provided

Work from home

Job summary

Vector Outsourcing Solutions Philippines is seeking a Prior Authorization Specialist to handle requests using the EHR system or phone/fax, monitor progress, review medical history and insurance coverage for approvals, and manage correspondence with insurers, physicians, and patients.

The position is work-from-home with night shifts; a Bachelor’s degree (preferably medical) is preferred, plus at least 1 year of prior authorization experience in a healthcare BPO. Equipment is provided.

Qualifications

• Graduate of Bachelor's Degree (preferably in Medical, but not required).
• Consultancy basis minimum of 6 months consultancy contract (subject for renewal).
• At least 1 year of background with Prior Authorization under a BPO healthcare account is an advantage.
• Must have excellent English communication skills, both written and oral.
• Ability to prioritize and organize multiple tasks.
• Willing to work in shifting schedules, mostly night shift.
• Able to Work From Home, must have a reliable internet connection.

Responsibilities

• Receive requests for prior authorizations using the Scheduling module of the EHR and/or via phone or fax and ensure that they are closely monitored.
• Process referrals and submit medical records to insurance carriers to expedite prior authorization processes.
• Review the patient's medical history and insurance coverage for approval.
• Manage correspondence with insurance companies, physicians, specialists, and patients as needed, including documenting in the EHR as appropriate.
• Assist with the necessary documentation to expedite approvals and ensure that appropriate follow-up is performed.
• Review the accuracy and completeness of the information requested and ensure that all supporting documents are present.

Skills

English communication

Prioritization

Night shift

WFH readiness

Education

Bachelor's degree (medical preferred)

Job description

• Receive requests for prior authorizations using the Scheduling module of the Electronic Health Record (EHR) and/or via phone or fax and ensure that they are closely monitored.
• Process referrals and submit medical records to insurance carriers to expedite prior authorization processes.
• Review the patient's medical history and insurance coverage for approval.
• Manage correspondence with insurance companies, physicians, specialists, and patients as needed, including documenting in the EHR as appropriate.
• Assist with the necessary documentation to expedite approvals and ensure that appropriate follow-up is performed.
• Review the accuracy and completeness of the information requested and ensure that all supporting documents are present.

Salary: 30,000 PHP- 35,000/ month

Job Description:

• Receive requests for prior authorizations using the Scheduling module of the Electronic Health Record (EHR) and/or via phone or fax and ensure that they are closely monitored.
• Process referrals and submit medical records to insurance carriers to expedite prior authorization processes.
• Review the patient\'s medical history and insurance coverage for approval.
• Manage correspondence with insurance companies, physicians, specialists, and patients as needed, including documenting in the EHR as appropriate.
• Assist with the necessary documentation to expedite approvals and ensure that appropriate follow-up is performed.
• Review the accuracy and completeness of the information requested and ensure that all supporting documents are present.

Minimum Qualifications:

• Graduate of Bachelor\'s Degree (preferably in Medical, but not required)
• Consultancy basis minimum of 6 months consultancy contract (subject for renewal)

• At least 1 year of background with Prior Authorization under a BPO healthcare account is an advantage
• Must have excellent English communication skills, both written and oral
• Ability to prioritize and organize multiple tasks
• Willing to work in shifting schedules, mostly night shift
• Able to Work From Home, must have a reliable internet connection

Others:

• Equipment/ company computer is provided
• Work from Home