Remote Prior Authorization Specialist - US Healthcare

PsychPlus; Philippines; À distance; PHP 257 000 - 336 000; Plein temps

Résumé du poste

PsychPlus is seeking a detail-oriented Prior Authorization Specialist to support authorization processes for U.S. healthcare services. This remote role requires coordinating with insurance companies, providers, and internal teams to obtain and maintain authorizations, with emphasis on accuracy, timely follow-up, and adherence to U.S.

insurance workflows. The ideal candidate has experience with U.S. healthcare organizations and payer portals, and is able to work remotely from the Philippines,

Qualifications

• 1+ year of experience in U.S. healthcare prior authorization, insurance verification, medical billing, or Revenue Cycle Management
• Working knowledge of U.S. health insurance processes
• Experience communicating with U.S. insurance companies or payer representatives
• Experience using payer portals or electronic authorization systems
• Strong written and verbal English communication skills
• Strong attention to detail and organizational skills
• Ability to manage multiple authorization requests and follow-up deadlines
• Proficiency with Microsoft Excel or Google Sheets
• Ability to work independently in a remote environment
• Availability to work Monday to Friday, 9:00 AM to 6:00 PM U.S. Central Time

Responsabilités

• Review patient and insurance information to determine prior authorization requirements
• Submit prior authorization requests to insurance companies and payer portals
• Gather and organize required clinical and administrative documentation
• Follow up with insurance companies regarding pending authorization requests
• Track authorization status, approval dates, expiration dates, and reference numbers
• Communicate authorization requirements and status updates to internal teams
• Identify missing information or documentation that could delay authorization
• Maintain accurate authorization records in applicable healthcare systems
• Research payer-specific authorization requirements and procedures
• Escalate delayed, denied, or complex authorization requests when appropriate
• Maintain accurate documentation of communications and authorization outcomes
• Meet established accuracy, productivity, and turnaround time expectations
• Protect confidential patient and healthcare information

Connaissances

Prior authorization

Insurance verification

Communication

Attention to detail

Remote work

Outils

Payer portals

CollaborateMD

EMR/EHR

Practice management systems

Revenue Cycle Management systems

Description du poste

PsychPlus is seeking a detail-oriented Prior Authorization Specialist to support authorization processes for U.S. healthcare services. This remote role requires coordinating with insurance companies, providers, and internal teams to obtain and maintain authorizations, with emphasis on accuracy, timely follow-up, and adherence to U.S.

insurance workflows. The ideal candidate has experience with U.S. healthcare organizations and payer portals, and is able to work remotely from the Philippines,