Remote Prior Authorization Specialist - Dermatology

Skin And Cancer Institute; Philippinen; Remote; PHP 300.000 - 520.000; Vollzeit

Benefits dieser Stelle

Competitive salary

Night shift differential pay

Statutory benefits

Paid time off

Professional development opportunities

Supportive and fair work environment

Zusammenfassung

Skin and Cancer Institute is seeking a Prior Authorization Specialist for a remote, full-time role. You will determine authorization requirements, obtain preauthorizations, and manage documentation to support timely access to care while coordinating with patients, providers, and payers.

Role requires accuracy, strong communication, and ability to manage high-volume work within HIPAA and payer guidelines. Prior authorization expertise and EMR experience are essential.

Qualifikationen

• High school diploma or equivalent required.
• Minimum 2 years healthcare prior authorization, insurance verification, medical billing, revenue cycle, or related healthcare administrative experience.
• Experience with insurance carriers and payer authorization processes.
• Proficiency with Microsoft 365 and electronic health record systems.

Aufgaben

• Review orders to determine authorization requirements.
• Obtain authorizations and precertifications from plans and confirm eligibility or referral information.
• Submit requests with required clinical documentation, codes, units, frequency, rendering provider, and location.
• Monitor pending requests and follow up within required timeframes.
• Maintain authorization tracking in EMR/EMA and designated systems.
• Coordinate peer-to-peer reviews and appeals within policy and authority.
• Identify expiration dates and obtain extensions or updated approvals.

Kenntnisse

Prior authorization

Insurance verification

EMR systems

Microsoft 365

Communication skills

Attention to detail

Ausbildung

High School Diploma or equivalent

Associate's degree in healthcare administration (preferred)

Tools

EMA/Modernizing Medicine

NextGen EMR

Jobbeschreibung

Skin and Cancer Institute is seeking a Prior Authorization Specialist for a remote, full-time role. You will determine authorization requirements, obtain preauthorizations, and manage documentation to support timely access to care while coordinating with patients, providers, and payers.

Role requires accuracy, strong communication, and ability to manage high-volume work within HIPAA and payer guidelines. Prior authorization expertise and EMR experience are essential.