Prior Authorization & Surgical Scheduling Coordinator

iSupport Worldwide; Metro Manila; On-site; PHP 720,000 - 1,080,000; Full time

Benefits offered by this job

Above-industry salary package

HMO benefits

Life insurance from day 1

Learning & development courses

Promotion opportunities

Free meals and snacks

Job summary

iSupport Worldwide is hiring a highly organized Prior Authorization & Surgical Scheduling Coordinator to support multiple providers. The role handles authorizations, insurance verification, scheduling, and pre-operative documentation, ensuring HIPAA/PHI compliance while coordinating care across payer types.

Responsibilities include end-to-end authorizations, MAC and light anesthesia submissions, COB reviews, and EMR documentation.

Qualifications

• Bachelor's degree is advantageous.
• Two years of healthcare administrative experience with prior authorization or surgical scheduling is required.

Responsibilities

• Manage end-to-end prior authorizations, insurance verification, and pre-operative documentation for assigned providers.
• Submit prior authorization requests for MAC and light anesthesia procedures within required timelines.
• Verify patient eligibility, coverage, deductibles, coinsurance and COB across multiple payer types.
• Gather and submit clinical documentation and diagnostic imaging to satisfy payer requirements.
• Schedule procedures in eCW to ensure adequate anesthesia coverage.
• Coordinate post-operative appointments and maintain scheduling accuracy.
• Maintain accurate EMR records and comply with HIPAA and PHI protections.
• Escalate cases requiring clinical review and ensure timely resolution.
• Protect patient data with secure handling and documentation practices.

Skills

Prior authorizations

Insurance verification

Surgical scheduling

HIPAA compliance

PHI handling

COB (Coordination of Benefits)

EMR/EHR proficiency

eClinicalWorks (eCW)

CPT & ICD-10 coding

Clinical documentation

Attention to detail

Time management

Education

Bachelor's degree in healthcare/business or related field

Tools

eClinicalWorks (eCW)

EMR/EHR platforms

Job description

Work Schedule: US Working Hours / Night Shift

Work Location: Cyberscape Alpha, Ortigas Center, Pasig City (Onsite)

What is your mission?

We are looking for a highly organized Prior Authorization & Surgical Scheduling Coordinator to support multiple providers by managing prior authorizations, insurance verification, surgical scheduling, and pre-operative documentation. The role is responsible for coordinating procedure cases, verifying eligibility and benefits, compiling required clinical documentation, maintaining scheduling coverage, and ensuring compliance with HIPAA, Protected Health Information (PHI) protocols, and payer-specific requirements while supporting efficient surgical operations.

You will provide the best service to our partner brands by performing these tasks:

• Manage end-to-end prior authorizations, insurance verification, and pre-operative documentation for assigned providers.

• Submit prior authorization requests for MAC and light anesthesia procedures accurately and within required timelines.

• Verify patient eligibility, coverage, deductibles, coinsurance, and Coordination of Benefits (COB) across commercial insurance plans, Medicare, Medicaid, Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), Workers' Compensation, and Motor Vehicle Accident (MVA) claims.

• Gather, organize, and submit required clinical documentation and diagnostic imaging to satisfy payer medical necessity requirements.

• Schedule procedure cases in eClinicalWorks (eCW) to maintain adequate anesthesia coverage across assigned providers.

• Coordinate post-operative appointments for designated internal providers and ensure scheduling accuracy.

• Maintain accurate patient, insurance, authorization, and scheduling records within Electronic Medical Record (EMR) systems.

• Follow established escalation procedures for cases requiring clinical review or judgment.

• Maintain strict compliance with HIPAA guidelines, PHI protocols, confidentiality standards, and organizational security procedures.

• Verify patient identity and authorization before releasing or discussing protected information.

• Utilize secure documentation, portal communication, faxing, and information-handling processes to safeguard patient data.

• Report suspected privacy, security, or confidentiality incidents according to organizational policies.

Who are we looking for?

• Bachelor's degree in any healthcare-related, business, or relevant field is an advantage.

• At least 2 years of healthcare administrative experience with a strong background in prior authorization, insurance verification, or surgical scheduling.

• Proven experience handling surgical prior authorization submissions, insurance eligibility verification, Coordination of Benefits (COB), deductibles, and coinsurance reviews.

• Experience supporting multiple providers while managing a high-volume authorization and scheduling pipeline.

• Experience working in healthcare accounts, specialty clinics, pain management, surgical practices, or related healthcare environments.

• Experience with Electronic Medical Record (EMR/EHR) platforms; eClinicalWorks (eCW) experience is highly preferred.

• Working knowledge of Current Procedural Terminology (CPT) and International Classification of Diseases, Tenth Revision (ICD-10) coding related to prior authorization submissions.

• Ability to compile and submit clinical documentation and diagnostic records in accordance with payer requirements.

• Familiarity with MAC and light anesthesia procedure authorizations is preferred.

• Strong knowledge of insurance benefits, payer guidelines, authorization workflows, and healthcare documentation processes.

• Ability to maintain strict confidentiality and properly handle Protected Health Information (PHI).

• Strong attention to detail and accuracy.

• Excellent organizational and time management skills with the ability to meet daily productivity targets.

• Strong problem-solving and follow-through skills when managing authorization requests, appeals, and urgent cases.

• Effective written and verbal communication skills.

• Dependable, punctual, and comfortable working on a permanent night shift schedule.

• Adaptable and capable of managing changing priorities in a fast-paced healthcare environment.

Company Perks:

• Above-industry salary package and incentives

• Comprehensive HMO benefits and life insurance from day 1

• Free learning and development courses for your personal and career growth

• Dynamic company events

• Opportunities for promotion

• Free meals and snacks