Prior Authorization Specialist — Healthcare Verifications

Hammerjack Pty Ltd; Philippines; On-site; PHP 240,000 - 300,000; Full time

Benefits offered by this job

Competitive compensation

Signing bonus Php 5,000

Life insurance

HMO Insurance

Annual merit increase

Night differential

Onsite location Ortigas

Great company culture

Job summary

Connext Global Solutions is seeking a Prior Authorization Specialist to support a U.S. client from its Ortigas office in the Philippines." The role focuses on verifications and obtaining prior authorizations for a range of therapy services, requiring strong communication and organizational skills.

The candidate will interact with insurers, understand various plan types, and ensure timely processing compliant with insurance requirements.

Qualifications

• Minimum of one year experience with medical billing and/or understanding of benefits including deductibles, co-insurance, out of pocket and benefits exclusions.

Responsibilities

• Conduct insurance verifications and obtain prior authorizations for therapy services (Physical, Occupational, Speech, Autism, Outpatient Behavioral Health).
• Call insurers to collect benefits and confirm authorization status.
• Navigate insurance portals and apply knowledge of CPT coding and billing processes.
• Communicate clearly in English with providers, patients, and insurers.
• Work efficiently under deadlines and manage multiple tasks.

Skills

Phone etiquette

Customer service

English communication

Organizational skills

Multi-tasking

Tools

EMR/EHR systems

PMS (Practice Management Systems)

Insurance portals

Job description

Connext Global Solutions is seeking a Prior Authorization Specialist to support a U.S. client from its Ortigas office in the Philippines." The role focuses on verifications and obtaining prior authorizations for a range of therapy services, requiring strong communication and organizational skills.

The candidate will interact with insurers, understand various plan types, and ensure timely processing compliant with insurance requirements.