Prior Authorization Specialist

ScribeRunner; Biñan; On-site; PHP 260,000 - 360,000; Full time

Job summary

ScribeRunner is a people-and-technology company delivering complex healthcare workflows through AI and expert teams in the Philippines.

The Prior Authorization Specialist role is on-site in Biñan, focused on verifying eligibility, reviewing documentation, and submitting payer requests in line with client protocols.

Qualifications

• Experience with prior authorization processes, insurance verification, and basic revenue cycle workflows in a healthcare setting.
• Strong data entry, documentation, and record-keeping skills with high attention to detail and accuracy.
• Ability to interpret insurance policies, clinical documentation, and payer guidelines to support authorization decisions.
• Effective communication skills for interacting with payers, clinicians, administrative staff, and patients in a professional manner.
• Proficiency with healthcare software systems, payer portals, and common office productivity tools.
• Strong organizational and time management skills, with the ability to prioritize multiple authorization requests and meet deadlines.
• Problem-solving mindset with the ability to navigate complex workflows, resolve authorization issues, and adapt to changing requirements.
• Previous experience in a clinic, physician group, or similar healthcare environment is preferred; knowledge of outpatient and insurance processes is a plus.
• High school diploma or equivalent required; additional training or education in healthcare administration, nursing, or a related field is an advantage.
• Commitment to

Responsibilities

• Manage prior authorization requests by verifying patient eligibility.
• Review clinical documentation and submit authorization requests to payers per client protocols.
• Track authorization status, follow up with payers, and communicate outcomes to teams.
• Enter data accurately into client and payer systems and maintain up-to-date policy knowledge.
• Resolve authorization-related issues and escalate complex cases when needed.
• Collaborate with cross-functional teams and contribute to process improvements.
• Support a patient-centered, compliant environment.

Skills

Attention to detail

Strong communication

Data entry accuracy

Policy interpretation

Time management

Cross-functional collaboration

Problem solving

Clinic/physician group experience

Adaptability

Education

High school diploma or equivalent

Healthcare administration training

Tools

Healthcare software systems

Payer portals

Office productivity tools

Job description

Company Description

ScribeRunner is a people-and-technology company that helps healthcare and legal teams complete complex work using a combination of ScribeRunnerAI (SAI) and expert human teams. The organization focuses on long-term careers, investing in training, growth, and advancement so team members can take ownership of outcomes and deliver high-quality work. ScribeRunner supports outpatient clinics, physician groups, skilled nursing facilities, legal teams, hospitals, and other compliance-driven organizations with services such as patient coordination, documentation, insurance verification, prior authorization, and revenue cycle management. Global teams in the United States, Colombia, India, the Philippines, and Pakistan help clients improve operations, optimize revenue, and reduce burnout through efficient, accurate workflows. The company is committed to quality and security, holding ISO 9001, ISO 27001, and SOC 2 Type II certifications, with HITRUST in progress.

Role Description

The Prior Authorization Specialist is a full-time, on-site role based in Biñan. This role is responsible for managing prior authorization requests by verifying patient eligibility, reviewing clinical documentation, and submitting authorization requests to payers in alignment with client protocols and insurer requirements. The specialist will track authorization status, follow up with payers, and communicate outcomes and next steps to clinical, billing, and scheduling teams. Day-to-day tasks include accurate data entry into client and payer systems, maintaining up-to-date knowledge of insurance policies, resolving authorization-related issues, and escalating complex cases when needed. The role also involves collaborating with cross-functional teams, supporting continuous process improvements, and contributing to a patient-centered, compliance-driven environment.

Qualifications

• Experience with prior authorization processes, insurance verification, and basic revenue cycle workflows in a healthcare setting.
• Strong data entry, documentation, and record-keeping skills with high attention to detail and accuracy.
• Ability to interpret insurance policies, clinical documentation, and payer guidelines to support authorization decisions.
• Effective communication skills for interacting with payers, clinicians, administrative staff, and patients in a professional manner.
• Proficiency with healthcare software systems, payer portals, and common office productivity tools.
• Strong organizational and time management skills, with the ability to prioritize multiple authorization requests and meet deadlines.
• Problem‑solving mindset with the ability to navigate complex workflows, resolve authorization issues, and adapt to changing requirements.
• Previous experience in a clinic, physician group, or similar healthcare environment is preferred; knowledge of outpatient and insurance processes is a plus.
• High school diploma or equivalent required; additional training or education in healthcare administration, nursing, or a related field is an advantage.
• Commitment to