Prior Authorization Specialist: Streamline Medical Approvals

HRTX; Pasig; On-site; PHP 406,000 - 487,000; Full time

Job summary

HRTX in Ortigas is seeking a meticulous Prior Authorization Specialist to manage requests and ensure payer compliance. The role supports healthcare providers in securing approvals for medical services and procedures, coordinating with insurers, providers, and patients.

The successful candidate will review documentation, track authorizations, and maintain accurate records to support timely patient care and audit readiness.

Qualifications

• Detail-oriented and motivated candidate.
• Background in the medical allied field.

Responsibilities

• Process and manage prior authorization requests for medical services, procedures, and medications.
• Review clinical documentation and ensure compliance with payer guidelines and requirements.
• Communicate with healthcare providers, insurance companies, and patients to facilitate approvals.
• Track, follow up, and resolve pending authorizations in a timely manner.
• Document all activities accurately within the system for auditing and compliance purposes.
• Collaborate with internal teams to ensure smooth workflow and process efficiency.

Job description

HRTX in Ortigas is seeking a meticulous Prior Authorization Specialist to manage requests and ensure payer compliance. The role supports healthcare providers in securing approvals for medical services and procedures, coordinating with insurers, providers, and patients.

The successful candidate will review documentation, track authorizations, and maintain accurate records to support timely patient care and audit readiness.