Prior Authorization Specialist – Pharmacy & Patient Care

DME Service Solutions; Philippines; Remote; PHP 180,000 - 360,000; Full time

Job summary

DME Service Solutions in the Philippines is seeking a Prior Authorization Associate to support healthcare providers and patients by initiating requests and verifying forms.

You will coordinate with prescribers, offices, and insurers to ensure accurate PA documentation, follow up on statuses, and communicate outcomes to stakeholders. A strong communicator with attention to detail and healthcare knowledge will thrive in this patient‑focused role.

Qualifications

• Customer service or inbound call center experience required.
• Strong verbal and written communication skills.
• Sound technical skills, analytical ability, attention to detail, good judgment and operational focus.
• A passion for providing top-notch patient care.
• Ability to work with peers in a team and cross-functional setting.
• 1+ year working with prior authorizations or insurance verification in a pharmacy (preferred).
• Knowledge of pharmacy benefits and pharmacy claims (preferred).

Responsibilities

• Assist in the initiation of new prior authorization requests to providers.
• Identify the correct prior authorization form required for the patient's insurance provider.
• Coordinate with prescribers and medical offices to ensure information is translated onto forms.
• Follow up with medical offices to check the status of prior authorization requests.
• Communicate the status of prior authorizations to patients and providers.
• Coordinate with medical offices to handle Appeals.
• Respond to internal questions from other departments related to prior authorization requests.

Skills

Customer service

Communication skills

Teamwork

Attention to detail

Analytical ability

Pharmacy knowledge

Education

High school diploma or GED

Bachelor's degree

Job description

DME Service Solutions in the Philippines is seeking a Prior Authorization Associate to support healthcare providers and patients by initiating requests and verifying forms.

You will coordinate with prescribers, offices, and insurers to ensure accurate PA documentation, follow up on statuses, and communicate outcomes to stakeholders. A strong communicator with attention to detail and healthcare knowledge will thrive in this patient‑focused role.