Prior Authorization Specialist (Onsite in ORTIGAS + 25% NIGHT DIFFERENTIAL + PHP5,000SOB)

Connext; Pasig; On-site; PHP 268,000 - 402,000; Full time

Benefits offered by this job

Life insurance

HMO Insurance

Annual Merit Increase

Night Differential 25%

Signing bonus Php 5,000

Job summary

Connext Global Solutions is seeking a detail-oriented Prior Authorization Specialist to support therapy services in the United States. You will verify benefits, obtain prior authorizations, and coordinate with insurers to ensure timely processing.

The ideal candidate has at least one year of medical billing experience, familiarity with EMR/EHR and PMS, and demonstrates clear English communication and strong organizational skills.

Qualifications

• Minimum of one year experience with medical billing and understanding of benefits including deductibles, co-insurance, out of pocket and exclusions.
• Experience with EMR/EHR and Practice Management Systems (PMS).
• Stable employment history.

Responsibilities

• Verify insurance and obtain prior authorizations for therapy services.
• Call insurers to collect benefits and confirm authorization status.
• Navigate insurance portals and codes as needed.
• Apply knowledge of CPT coding for medical billing.
• Work under deadlines with high attention to detail.
• Communicate clearly in written and spoken English.

Skills

Customer service

Phone etiquette

Insurance understanding

Insurance portals

Medical billing

Communication skills

Time management

Tools

EMR/EHR

PMS

Job description

Connext Global Solutions is a dedicated team of business process outsourcing experts and innovators, with experience in supporting world-class companies in Title and Escrow, Healthcare, Produce Distribution, Retail and Fashion, Design Consulting, and Finance.

We are currently looking for an Prior Authorization Specialist who will be working with Connext's Client in the United States of America.

What's in it for you?

• Competitive compensation
• Perfect Attendance Bonus
• Life insurance
• HMO Insurance
• Great company culture
• Annual Merit Increase
• 25% Night Differential
• Signing bonus Php 5,000

What is the job?

The Prior Authorization Specialist is responsible for conducting insurance verifications and obtaining prior authorizations for a diverse range of therapy services, including Physical Therapy, Occupational Therapy, Speech Therapy, Autism Therapy, and Outpatient Behavioral Health. This role requires a knowledgeable, organized, and professional individual with excellent communication skills to ensure timely processing and compliance with insurance requirements.

• Phone etiquette and customer service skills, experience calling insurers to collect benefits and confirm authorization status.
• Has understanding with HMOs, PPOs, POSs, EPOs, Medicare, Medicaid through the referral and authorization process.
• Familiarity with navigating insurance portals.
• Demonstrates strong understanding of insurance policies and medical billing processes including CPT coding.
• Work ethic to operate with urgency, work independently, be highly organized, detailed oriented and multi-task effectively.
• Work efficiently under deadlines.
• Clear and coherent both written and verbal communication skills in English.

Required Qualifications:

• Minimum of one (1) year experience with medical billing and/or understanding of benefits including deductibles, co-insurance, out of pocket and benefits exclusions.
• Experience in providers software, including Electronic Medical Record Systems (EMR/EHR) and Practice Management Systems (PMS).
• Must have a stable employment history.