Referral & Prior Auth Specialist

Outsource Accelerator; Pasig; On-site; PHP 360,000 - 540,000; Full time

Job summary

Outsource Accelerator in Pasig, Philippines, is looking for a Clinic Referral & Prior Authorization coordinator to manage the coordination and completion of patient referrals and authorization requirements, ensuring accuracy and timeliness to support access and minimize delays.

You will verify insurance eligibility, enter data in EMR and payer systems, obtain authorizations, monitor status, and communicate decisions to clinic staff, with a strong focus on accuracy, attention to detail, and

Qualifications

• Strong problem-solving and analytical skills.
• Meticulous attention to detail in reviewing referrals and authorizations.
• Ability to plan, organize, and prioritize multiple requests.
• Effective communication with patients, clinics, and payers.

Responsibilities

• Reviews and processes referral and prior authorization requests.
• Verifies patient insurance eligibility and determines requirements.
• Enters and maintains referral and authorization data in systems.
• Obtains referrals and authorizations from insurers with required docs.
• Monitors and follows up on pending referrals and determinations.
• Communicates status and payer decisions to clinic staff.
• Identifies information gaps and coordinates follow-up actions.
• Maintains accurate documentation of all activity.

Skills

Problem solving

Attention to detail

Planning/organizing

Communication

Teamwork

Quantity and quality

Customer service

Job description

Outsource Accelerator in Pasig, Philippines, is looking for a Clinic Referral & Prior Authorization coordinator to manage the coordination and completion of patient referrals and authorization requirements, ensuring accuracy and timeliness to support access and minimize delays.

You will verify insurance eligibility, enter data in EMR and payer systems, obtain authorizations, monitor status, and communicate decisions to clinic staff, with a strong focus on accuracy, attention to detail, and