Remote Home Health Authorization Specialist

AdminEdge; Metro Manila; Remote; PHP 614,000 - 702,000; Part time

Benefits offered by this job

Fully remote

Fixed US schedule

PTO: 10 days + 6 holidays

Job summary

AdminEdge is seeking a Home Health Authorizations Coordinator (Remote - US Client) in the Philippines. This part-time role (20 hours/week) supports insurance authorization workflows, including submissions, validation of payer requirements, and tracking approvals.

PST-hours alignment is required. The ideal candidate has at least 3 years in US healthcare authorizations, strong communication, and the ability to navigate multiple payer portals.

Qualifications

• Minimum 3 years of experience supporting US-based healthcare organizations, preferably in home health authorizations or revenue cycle.
• Experience processing prior authorizations for US home health services.
• Knowledge of managed care plans (commercial, Medicaid, Medicare Advantage, HMOs, IPAs).
• Understanding of home health skilled nursing, therapy, and clinical documentation requirements.
• Ability to navigate payer portals, identify required documentation, and escalate issues.

Responsibilities

• Prepare, submit, and track initial and ongoing authorization requests for home health services.
• Review referrals, physician orders, diagnoses, and clinical records to identify information for authorization.
• Verify medical necessity and supporting documentation for requested skilled services.
• Identify patient diagnoses and clinical justification for requested services.
• Submit authorizations through payer portals and medical group platforms.
• Monitor pending authorizations and follow up with payers and groups.
• Track approval dates, authorized visits, and expiration dates.
• Assist with extensions and reauthorization submissions.
• Escalate missing information or coverage issues as needed.

Skills

English fluency

US healthcare knowledge

Prior auth experience

Healthcare documentation

Attention to detail

Remote collaboration

Job description

AdminEdge is seeking a Home Health Authorizations Coordinator (Remote - US Client) in the Philippines. This part-time role (20 hours/week) supports insurance authorization workflows, including submissions, validation of payer requirements, and tracking approvals.

PST-hours alignment is required. The ideal candidate has at least 3 years in US healthcare authorizations, strong communication, and the ability to navigate multiple payer portals.