Prior Authorization Specialist

Altrue; Urdaneta; On-site; PHP 469,000 - 737,000; Full time

Benefits offered by this job

Structured environment

Leadership

Growth opportunities

Stable office

Team culture

U.S. healthcare exposure

Job summary

ALTRUST Services is hiring a detail-oriented Prior Authorization Specialist to support U.S.-based healthcare providers from our office-based operations. You will manage prior authorizations, verify insurance coverage, and follow up with payers while coordinating with providers and internal teams.

This role requires experience with EMR/EHR systems and payer portals, strong English communication, and the ability to work night shifts in U.S. time zones.

Qualifications

• 1–2 years in prior authorization, insurance verification, or U.S. healthcare support.
• Strong understanding of U.S. healthcare insurance processes and payer workflows.
• Excellent English communication skills (written and verbal).
• Attention to detail and strong organizational skills.
• Ability to manage multiple cases and deadlines simultaneously.
• Experience using EMR/EHR systems, payer portals, or healthcare platforms.
• Comfortable working night shift (U.S. time zone).
• Professional communication and problem-solving skills.
• Experience with U.S. prior authorization workflows.
• Background in healthcare BPO or healthcare operations.
• Familiarity with HIPAA-conscious workflows and documentation.

Responsibilities

• Submit and manage prior authorization requests for medications, procedures, imaging, and treatments.
• Complete payer forms and portal submissions accurately and efficiently.
• Ensure all required clinical documentation is attached and properly submitted.
• Track authorization statuses and follow up on pending requests.
• Verify patient insurance coverage, benefits, and eligibility.
• Review payer requirements for authorization approval.
• Identify missing information or documentation that may delay approvals.
• Contact insurance companies regarding authorization status, denials, and additional requirements.
• Escalate urgent or delayed cases as needed.
• Document all payer interactions accurately in internal systems.
• Coordinate with healthcare providers and clinical staff to obtain supporting documentation.
• Communicate authorization updates and outstanding requirements when needed.
• Ensure timely processing to avoid treatment delays.
• Maintain accurate and organized authorization records.
• Update tracking systems and internal databases consistently.
• Ensure compliance with documentation standards and confidentiality requirements.
• Assist in improving prior authorization workflows and turnaround times.
• Support operational reporting and productivity tracking.
• Collaborate with supervisors and QA teams to maintain service quality.

Skills

English communication

Attention to detail

Organizational skills

Multitasking

Night shift readiness

Problem-solving

Prior authorization workflows

Healthcare operations

Office-based support

HIPAA compliance

EMR/EHR familiarity

Tools

Availity

CoverMyMeds

Athenahealth

Kareo

Epic

eClinicalWorks

Job description

We’re Hiring: Prior Authorization Specialist

ALTRUST Services is looking for detail-oriented and highly organized Prior Authorization Specialists to support healthcare operations for U.S.-based medical providers and healthcare organizations.

This role is responsible for managing prior authorization requests, insurance verification, payer follow-ups, and documentation coordination to help ensure timely approvals and uninterrupted patient care.

You will work closely with healthcare providers, insurance payers, and internal support teams in a structured, office-based healthcare operations environment.

If you are proactive, process-driven, and experienced in U.S. healthcare workflows, we’d love to hear from you.

Key Responsibilities

Prior Authorization Processing

• Submit and manage prior authorization requests for medications, procedures, imaging, and treatments
• Complete payer forms and portal submissions accurately and efficiently
• Ensure all required clinical documentation is attached and properly submitted
• Track authorization statuses and follow up on pending requests

Insurance Verification & Eligibility

• Verify patient insurance coverage, benefits, and eligibility
• Review payer requirements for authorization approval
• Identify missing information or documentation that may delay approvals

Payer Follow-Up & Communication

• Contact insurance companies regarding authorization status, denials, and additional requirements
• Escalate urgent or delayed cases when necessary
• Document all payer interactions accurately in internal systems

Provider & Patient Coordination

• Coordinate with healthcare providers and clinical staff to obtain supporting documentation
• Communicate authorization updates and outstanding requirements when needed
• Ensure timely processing to avoid treatment delays

Documentation & Record Management

• Maintain accurate and organized authorization records
• Update tracking systems and internal databases consistently
• Ensure compliance with company documentation standards and confidentiality requirements

Workflow & Operational Support

• Assist in improving prior authorization workflows and turnaround times
• Support operational reporting and productivity tracking
• Collaborate with supervisors and QA teams to maintain service quality

Must-Have Qualifications

• At least 1–2 years experience in prior authorization, insurance verification, medical billing, or U.S. healthcare support
• Strong understanding of U.S. healthcare insurance processes and payer workflows
• Excellent English communication skills (written and verbal)
• Strong attention to detail and organizational skills
• Ability to manage multiple cases and deadlines simultaneously
• Experience using EMR/EHR systems, payer portals, or healthcare platforms
• Comfortable working night shift (U.S. time zone)
• Professional communication and problem-solving skills

Preferred Qualifications

• Experience handling U.S. prior authorization workflows
• Background in healthcare BPO or healthcare operations
• Familiarity with:
  • Availity
  • CoverMyMeds
  • Athenahealth
  • Kareo
  • Epic
  • eClinicalWorks
• Allied health or healthcare-related educational background
• Experience working in office-based healthcare support operations
• Familiarity with HIPAA-conscious workflows and documentation handling

Work Environment

This is an office-based role under ALTRUST Services’ supervised healthcare operations setup.

Work locations:

• Makati City
• Urdaneta City, Pangasinan

Our teams operate in structured, secure environments designed to support productivity, accountability, collaboration, and operational continuity.

Why Join ALTRUST Services?

• Structured healthcare operations environment
• Professional and supportive leadership
• Opportunities for long‑term growth
• Stable office-based setup
• Collaborative healthcare support culture
• Exposure to U.S. healthcare operations workflows