Radiology PA Specialist - Fast Pre-Auth & Scheduling

Tahche Outsourcing Services Inc; Cebu City; On-site; PHP 35,000 - 50,000; Full time

Job summary

Tahche Outsourcing Services Inc is seeking a Prior Authorization Specialist to work full-time on a US shift from the office. You will be responsible for obtaining pre-certifications for procedures and medications, scheduling outpatient tests, and managing patient calls.

Ideal candidates should have at least a 2nd-year level degree in Life Sciences, along with experience in the healthcare domain. Strong communication skills and knowledge of CPT codes are essential for this role.

Qualifications

• At least 6 months of experience in obtaining Pre-Authorization in a healthcare environment.
• Knowledgeable in CPT codes and DX codes.
• Familiar with different insurance portals and websites.

Responsibilities

• Responsible for day-to-day monitoring of the Radiology Worklist.
• Sorting of cases based on priority.
• Calling out to Insurance Companies for verification, referrals, and authorization process.
• Case creation in eviCore or another Insurance Portal as required.
• Request additional clinicals as needed.
• Review clinicals received and ensure it meets guidelines.
• Monitoring of pending cases for approval or denials.
• Make necessary follow-ups on pending/denied cases.
• Notification to the provider or medical assistant for pending or denied cases.

Skills

Good verbal and written communication

Detail Oriented

Good understanding of the Pre-Certification Process

Education

2nd-year level/Graduate/Postgraduate/Doctorate degree in Life Sciences

Tools

eviCore

Job description

Tahche Outsourcing Services Inc is seeking a Prior Authorization Specialist to work full-time on a US shift from the office. You will be responsible for obtaining pre-certifications for procedures and medications, scheduling outpatient tests, and managing patient calls.

Ideal candidates should have at least a 2nd-year level degree in Life Sciences, along with experience in the healthcare domain. Strong communication skills and knowledge of CPT codes are essential for this role.